Application for Multi-Institutional Degree Planning Support
for Breakthrough Bible College & Theological Seminary

Student's Name:

Student's E-mail address:

Address for us to contact the student when necessary (e.g. 123 Wherever Lane, Forestville, MD 20747):

Student's telephone number: This number is to the student's ...      home       work      cell phone

When is the best time of day for us to reach the student? 

Early morning before work (6:30 to 8:30)        Morning (8:30 to 12:00)    
Afternoon (12:00 to 5:30)     Evening (5:30 to 9:00)

Background Information - Past Accomplishments:

The student's status at BBC&TS &TS: New student, not yet taken BBC&TS courses     Seasoned student, having completed BBC&TS courses  

(Note: If the student has already completed BBC&TS courses in the past, we will need a student record of previous courses completed faxed to the Counseling Center at 850-478-3664.)   

Check here if the student has taken courses at a local traditional college.  (If so, we will need you to fax us a copy of transcripts from the colleges.)

Check here if you have ever passed college level examinations (AP, CLEP, DSST, etc.)

Check here if you have ever earned professional certification/licenses (FAA, ASE, Microsoft, etc.)

Check here if you have attended professional training through a corporation or government agency.

Check here if you have ever served in the Military, active or reserve.

If yes, in which branch of the military: Army Navy Air Force Marine Corps Coast Guard Army Reserve Army National Guard Navy Reserve Air Force Reserve Air National Guard Marine Corps Reserve Coast Guard Reserve

Current status: Veteran, Now Separated From the Military Retired Military Active Duty Military Reservist Called to Active Duty Currently Serving in the Ready Reserve Highest Pay Grade: E1 E2 E3 E4 E5 E6 E7 E8 E9 W1 W2 W3 W4 W5 O1 O2 O3 O4 O5 O6 O7 O8 O9 O10 GS GM WG

Non-ministry related degree goals:

Applicant's first non-ministry academic goal - What does the student hope to achieve in the short term?: High School Completion Associate's Degree Bachelor's Degree Master's Degree Doctorate Degree (using federal student aid)

Applicant's ultimate non-ministry academic goal - What does the student hope to achieve in the long term?: High School Completion Associate's Degree Bachelor's Degree Master's Degree Doctorate Degree (using federal student aid)

Because there are hundreds of subjects available at a distance, with thousands of degrees in our state-of-the-art degree exploration system, there are too many subjects to list here. As such, we need you to tell us what subject(s) you are interested in studying. In the space below, please tell us the academic goal that the student would like to achieve through state and community colleges or other private secular colleges and universities offering degrees in non-ministry related subjects (In other words - what is the student's goal in non-ministry related degrees?)

Applicant's current level of education at traditional colleges and universities - non-ministry related: Need to complete high school High school graduate Completed some college courses Earned an Associate's Degree Earned a Bachelor's degree Completed some graduate courses Earned a Master's degree Earned a PhD, EdD or similar degree

Ministry related degree goals:

Has this student already earned one or more degrees through BBC&TS? If so, which degrees (select all that apply):

Biblical Studies: Associate's Bachelor's Master's Doctorate

Christian Counseling: Associate's Bachelor's Master's Doctorate

Christian Education: Associate's Bachelor's Master's Doctorate

Church Administration: Associate's Bachelor's Master's Doctorate

Divinity: Associate's Bachelor's Master's Doctorate

Evangelism and Missions: Associate's Bachelor's Master's Doctorate

Pastoral Studies: Associate's Bachelor's Master's Doctorate

Theology: Associate's Bachelor's Master's Doctorate

Applicant's first academic goal at BBC&TS - What does the student hope to achieve in the short term?: High School Completion Associate's Degree Bachelor's Degree Master's Degree Doctorate Degree (using federal student aid)

In which field of study is the student pursuing a degreein the short term?: Biblical Studies Christian Counseling Christian Education Church Administration Divinity Evangelism and Missions Theology Pastoral Studies

Applicant's ultimate academic goal at BBC&TS - What does the student hope to achieve in the long term?: Associate's Degree Bachelor's Degree Master's Degree Doctorate Degree (using federal student aid)

In what subject or field of study are you most interested in the long term?: Biblical Studies Christian Counseling Christian Education Church Administration Divinity Evangelism and Missions Theology Pastoral Studies

Authorization to provide support to this student:

Please enter your Support Code in this section: 4971 Alpha 01 Bravo 39 Sierra 10 Tango 35 Other (Note: This must match the next field below)

Please identify the staff member at BBC&TS that authorizes support for this student: Dr. Moxley Dr. Gamble Dr. L. Greene Dr. Mays Other - please specify

If other, please enter the name of the staff member here, if not on the list above:

Phone number of the staff member submitting the student for support, in case we have questions for you:

How to submit this form:  When you press the submit button below, your computer will transmit the information to us and present you with a screen that thanks you for letting us serve as your advocate.  One of our staff will send you an e-mail either the same day or the following business day after submission of your support request.

After you press the submit button and are notified that we have received your submission, you may return to any other page on this website. Some people mistakenly think that seeing their responses still in the form above means their form was not sent to us, however, if you are told that it was submitted, we have, in fact, received it.

If this does not submit on your computer, please print the form below and fax it to us. Our fax number is (850) 478-3664.  If you are having difficulty with this or have any questions, please contact us via e-mail.