LCBI Student Application Form

Your Path to Biblical Distance Education

Personal Information

* if applicable

Full Name(Required)

Address(Required)

City, State, Zip Code(Required)

Phone Number(Required)

Email Address(Required)

Date of Birth(Required)

High School Graduation Date(Required)

GED Completion Date *(Required)

Any College or Seminary Education *(Required)

How did you hear about us ?(Required)

Academic Goals

Program of Interest(Required)

Non-Refundable Application fee | $30.00*

Single course | $90.00

Discounted Course | $81.00**

Course Module | $349.00

Discounted Module | $329.00**

Associates Degree in Biblical Studies | $500.00

*New students must pay application fee
**Please see tuition and fees page for more information.

Why LCBI? (Briefly explain in one or two lines)

Course Name

Statement of Faith

Briefly explain in one or two lines

Recommendations

Reference 1

Reference 2

Name

Email Address

Special Discounts

Upload Proof ( if you’re a pastor, deacons, church leadership, clergy, ministers, sunday school teachers, missionaries, veterans, service member, spouse of a service member, or first responder)

Max. file size: 100 MB.

If you’re not eligible for discounted price. You will be charged the regular price.

Signature & Date

Signature

Date

Credit Card

Total

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