A Pplic A Tion: Please Print or Type Clearly
A Pplic A Tion: Please Print or Type Clearly
2719 Sandmere, Saint Lazare, Quebec J7T 2J2 Tel. [514] 915-0771 Dr. Terrance Jenkins, Ph. D., D-C.P.C., Chancellor
APPLICATION
(A $50.00 application fee must accompany this form [Canadian or US funds]). Otherwise application will not be processed.
Please Print or Type clearly (As you want it to appear on your Certificate): Full Name: Address: Postal Code: Home Phone: Local Church:
Master of Christian Counseling Degree Master of Theological Studies Master of Divinity Degree Doctor of Theology Degree
Certificate in Ministry / Christian Counseling Associate of Ministry / Counseling Degree Bachelor of Ministry Degree Bachelor of Christian Ministry [Counseling Major]
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To College / University:
Degree Obtained
C it y : To
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Degree Obtained
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Date