LWBI Student Registration Form

Today's Date

Your Information

Name *

First

Last

Address Line 1 *

Address Line 2

City

State

Zip Code

Email *

Home Phone

Cell Phone

Date of Birth

Age

Gender

Primary Language

Ethnic Background

Marital Status

Educational Background

Ministry Status

Do you have a personal relationship with Jesus Christ?

Yes
No

Do you attend church on a regular basis?

Yes
No

Have you volunteered/been part of any area of ministry?

Yes
No

Bible College Questions

What is your objective in attending this school?

How did you learn about this Bible College?

School Payment

Thank you for your interest in the Living Word Bible Institute. Please submit this form with the $50 non-refundable registration fee to the Registrar’s Office.

Non-Refundable Registration Free *

Price: $ 50.00