SPECIAL APPLICATION FORM

Application forms are only held for 30 days and, if not followed
up with further submissions of forms or tests to the college,
they will be discarded for non-use at that time.

- WARNING -
You will be asked at the end of this Application if
you have received prior approval to submit a Special Application form.
If you have NOT RECEIVED special permission to submit this form
DO NOT submit it. Instead you must submit a regular Application.
That application is found in the APPLICATION/TUTORIAL
that can be accessed from the website main page.
There are substantial penalties for submitting this current
Application and falsely claiming you have received
prior permission to do so. The penalties are stated in the
- WARNING - at the end of this Application form.

   ATTENTION- these instructions must be followed:
1. DO NOT use nicknames. Use only your legal name on all forms submitted to SLBC. Your academic file and all degrees issued will use the name you submit on this form.
2. Use proper capitalization of all information. Do not use all upper-case letters or all lower-case letters.
3. Your degree, when you earn it, will have your name spelled exactly as you have it spelled on your Application form.  Therefore, make sure you follow guidelines "1" and "2" exactly.
4. Do not use titles such as "Mr., Mrs., Pastor, Reverend, Bishop, etc." in the name fields because we file alphabetically.  Those titles are not allowed in your name as it is printed on your degree.  You may use "Jr." if your birth certificate and other legal documents show that as legally part of your name.  Otherwise, do not use it.
5. Do not use hyphenated last names (see "Exception") such as "Smith-Jones" because they cause filing problems. Choose which name you want to use, such as "Smith" or "Jones" and use it consistently in forms and other submissions to the college. We file alphabetically according to your last name.
Exception: If your name is hyphenated on your Birth Certificate, Social Security card, or other legal documentation, then you may hyphenate your name on the Application form. If you do so, you will be filed under the first letter of your hyphenated last name, and your degree, when you earn it, will have your name spelled with the hyphenation.
6. Do not use abbreviations when entering information on the form.

If you do not follow these guidelines then your Application may be rejected. If you do not follow these guidelines you will still receive an autoresponse welcome email telling you to continue; however, you will then receive notification that your application has been rejected and you will have to resubmit it following the guidelines exactly.

PLEASE CLICK HERE to keep these instructions open while you are filling out the Application form. Size both pages so that they fit side-by-side on your screen.

From the instructions page you can also print these instructions for reference should you choose to do so.

Fill out the following information and click 'Submit'.
* indicates a required field.

PERSONAL INFORMATION: 
*Original or Amended form: If you submitted an Application form anytime within the last 6 months or if you are an active student and you are submitting a change of info on your Application, please check Amended. Otherwise, check Original.
Original
Amended
*Last Name (Use only your family name with proper capitalization of the first letter):
*First Name (Use only your given name with proper capitalization of the first letter):
Middle Initial (If used- and use proper capitalization):Please enter only the initial for your middle name.
Suffix (II., III., Jr., Sr., etc.):
*Today's Date- use the calendar:
*Your Email:
*Verify Your Email:
*Street or PO address:
*City:
State: Other:  
*Country: Other:  
Zip or Postal Code (If you have one:)
Phone:
( )   -
Cell Phone:
( )   -
Work Phone:
( )   -
Fax:
( )   -
URL:
*Gender: 
*High School (12th grade) graduation date:If you did not graduate, then enter None in this field.
*High School Name:If you have not graduated or you have a GED, enter None in this field.
High School Address:
GED- enter year:If you do not have a GED, then leave this field blank.
CHURCH INFORMATION: If you currently have no Church, please enter None.
*Church Name (Do not use abbreviations):

Enter name of Denomination or affiliation in the next field.  If it is an
Independent Church, please enter Independent in that field.
(Do not use abbreviations.)

*Church's Affiliation:Name of denomination, or Independent, etc. If none, enter none in this box. Do not use initials.
*Pastor's Name:If no pastor enter None.
Pastor's Phone:
( )   -
Pastor's Email:
MINISTRY INFORMATION:
Are you currently or have you ever been involved in a ministry- Pastor, Associate pastor, Sunday School or other Church staff or other Church ministry such as Rescue Mission, Prison Ministry, Jail Ministry, Street preaching, regular visitation, Christian School, Church janitorial, Church bus or van driver, etc., whether paid staff or volunteer staff?


Use a comma to separate multiple ministries in the "Past and Present Ministries" field.
*Years In Ministry, if currently fulltime (number only.):If your are not now nor ever have been in the ministry, then enter a 0 in this box. Include all years total from the time you first helped out with anything in any ministries.
Past and Present Ministries (List ALL Christian service):Include all ministries in which you have been or are now involved in. This includes all ministries from the first time you ever helped out in Church.
SPIRITUAL INFORMATION:
*How long have you been saved:If not saved, enter None.
*When were you Baptized (Year): 
*Baptized by (Name of Church, NOT name of person):
OTHER INFORMATION:
*Why do you want to study with us?:
500 characters remaining.
*Birth Month:  *Birth Day:   *Birth Year:  
*Age: 
*City of Birth:
State of Birth (if born in the USA): 
*Country of Birth: Other:  
*Other schooling considered for credit transfer:
500 characters remaining. If none, enter None.
Scan and submit transcripts or attach transcript files (up to 10).
Select a file and click 'Add':

File(s) selected for upload:


LIFE EXPERIENCE:
1. Please list all Life Experience that you would like considered for credit.
2. Separate experience areas with commas.
3. Do NOT include any Ministry Experience in this Life Experience field.

Life Experience (Do NOT include Ministry Experience in this field): List all life experience for which you would like to receive consideration for credit. Separate experiences with commas.
By checking the following box student is verifying that all information on this form is accurate to the best of his or her knowledge.
*Information Accurate:
Yes.

If you are applying for a particular program such as, Master's program, Doctoral
program, etc., or you wish to add any other pertinent information to your
Application, please feel free to do so in this field.

Comments:
500 characters remaining.

ACCURATE INFORMATION:
Make sure the information is accurate before submitting this form.

SUBMISSION OF MORE THAN ONE FORM:
To prevent accidental submission of multiple forms, only one form per hour is
allowed from each IP.  Should you need to submit an Amended form with a
change of information, you will need to wait at least one hour to do so.

UNUSED APPLICATIONS: If you do not sign in and begin studying a course
within 30 days, then this Application will be discarded.  We know if you are
studying at least one of the courses because you will submit a Begin Sign In
form and, after meeting the minimum required attendance for the first lesson,
you will have submitted a lesson test.  Receipt of that test, pass or fail, will
verify that you have started your courses.  If we receive no correspondence
from you within 30 days of the date you submitted this Application, then we
will discard this Application because of non-use.

We have found it necessary to include the following second warning to all applicants:
If you do not use proper letter-case on all entries on this form, your Application will be rejected.
You are not allowed to use all upper-case letters, nor are you allowed to use all lower-case
letters on this form.  This includes when you input your name (the most common infraction)
and when inputting information into the various other fields- comments, other schooling, etc.
This is a college; therefore, college-level work is expected of all students at all times.
 

- THIRD AND FINAL WARNING -
You were instructed, twice, to NOT use all upper-case or all lower-case letters when filling
out this form.  By checking the "Yes" box you are verifying that you have followed
these instructions when filling out this form. You are also verifying that you
understand that if you did not follow those instructions your Application
will be rejected.  It is imperative that students follow all instructions
exactly.  The instructions are given to enable students to have
the best chance of receiving an education in the Word
of God.  Failure to follow instructions will negate
that possibility at the worst or, at the least,
make it extremely more difficult.
Dr. Van

*I verify that I have used proper letter-case for all information submitted on this form:
Yes No
*Have you ever submitted an Application to us in the past?
Yes. No. Don't know.
*Have you taken courses from us in the past?
Yes. No. Don't know.

ATTENTION: There has been some misunderstanding concerning the scope and purpose of Heritage Baptist College / Salt Lake Bible College.  We are a Religion and Bible college and our degrees are meant for Church/Religion uses only.  Our only purpose is what is stated on the opening page of our website: "Training Men and Women In the Word of God".  We are not a secular college and our degrees are not meant for secular purposes; but, rather, are meant for Church/Religious purposes.

Thank you and may God bless as you study,
Dr. T. E. VanBuskirk

*I understand SLBC degrees are meant for Church/Religious purposes:
Yes.

_________________________________________________________

NOTICE TO ALL STUDENTS!

ADMINISTRATIVE FEE

Notice to all students:

Due to the growth of SLBC, it has become imperative that we have more staff to handle the administrative work for our thousands of students.

Administrative Fee: To facilitate this need we are instituting an Administrative Fee of $15.00/month USD for all students.
This fee will enable us to obtain more staff and facilitate the needed expansion of our facilities to meet the needs of our expanding student body.

Free College Tuition and study materials and no charge for graduation: All of these will still be at no charge. Tuition will still be free and all study materials will still be available online at no charge to the students. Graduation and issuance of degrees will also remain free. In essence, the college will still be free. The Administrative Fee is only assessed to facilitate record-keeping for those students pursuing a degree.

Waiver will be available: For those students who cannot afford this fee, a Waiver Form will be available for those who need an exemption. We do not want anyone to drop out of the student body because of finances. If a student cannot afford the Administrative Fee they will be given an exemption. Our aim is to make sure everyone has an opportunity to gain an education in the Word of God. If you cannot afford the fee, please, submit a waiver form. However, if you can pay the fee without it being a financial burden, please do so in order to facilitate the administrative work for all students, both for those who can afford to pay the small fee and those who cannot. We ask that all students, whether they are subject to this fee or not, pray about it and then make their decision. The link to the Administrative Fee Waiver form is at the bottom of this page.

Date of change: This fee will go into effect January 1st of 2015.

Required: Please make your first Administrative Fee payment and your administrative account will be set up automatically.
Payment by check or money order:
1. If you pay by check or money order in your own name, the account will be set up in the name on that check or money order.
2. If the check or money order is sent by someone else for you, please have them indicate that the payment is for you and have them include your full name on it and the month for which the payment is made. Alternatively, have them send a note with the check or money order indicating that it is for you and have them include (1) your full name, and (2) the month for which the fee is to be applied.
Payment through PayPal: If you submit a payment through PayPal via the links below, your account will go into effect automatically in the name on the PayPal notice that is sent to us. You will also receive a receipt from PayPal indicating the amount of the payment and the month for which it is paid. A yearly option is also available which will save you 1 month's payment (you will be charged for 11 months and receive 12 months).

Monitoring Only students: Only students pursuing a college degree are subject to this fee. Those who are Monitoring Only, not for credit toward a degree, are not subject to this fee. We do not keep any records for Monitoring Only students; therefore, there is no administrative work and that makes them exempt from the Administrative Fee. However, if the student wishes to remit the fee to help with the administrative work for those students who cannot afford it, we ask that the student would consider doing so. They can help the less fortunate through this very small sacrifice.

REFUND NOTE: All Fees are non-refundable.

Keeping track of Fee submissions: It is the student's responsibility to keep track of submission of their Administrative Fees. You will receive an automatic receipt from PayPal for each payment made through them. Those receipts are dated and contain the amount paid and the month for which the fee is paid; therefore, if you keep them in a file you will always know what payments you have made. If you set up automatic payments with your bank, you won't have to be concerned about remembering when you made a payment. Your bank statements will show the date each payment was automatically sent out.

Thank you and may God bless you abundantly as you serve Him,
Dr. Van


Dr. T.E. VanBuskirk
President: Heritage Baptist College/Salt Lake Bible College
docvbk@saltlakebiblecollege.org

_________________________________________________________

1. By clicking the box below I verify that I have read the Administrative Fee notice.
2. By clicking the box below I also am verifying that I am aware that a Waiver form is
available for anyone for whom the fee would be a burden.

*Administrative Fee Verification Notice:
Yes

- WARNING -
Because of some Application problems that have arisen, all applicants must verify
that they have received SPECIAL PERMISSION to submit a Special Application form to SLBC.
If applicant gives false information in this matter they will be denied admission to Salt Lake Bible
College/Heritage Baptist College for six (6) months.
In addition, to be considered for application to SLBC after the six (6) month period
they will have to supply proof of counseling concerning their sin of lying. This proof must be
a statement from the counselor that the applicant has received counseling and has shown
evidence that he/she has been restored to proper Christian conduct in the matter of
truthfulness as demanded by Scripture. (James 5:12)
By answering the following question the applicant
is verifying that they have read this warning
and that they agree to abide by it.

*I verify that I have received PRIOR APPROVAL to submit a Special Application to SLBC:
Yes, I HAVE received prior approval.
No, I HAVE NOT received prior approval.