UACCCI - Student Application
United Graduate College and Seminary - United Association of Christian Chaplains and Counselors

United Graduate College and Seminary
Student Application

Which Certificate or Degree are you applying for?  
Name:  Last____________________ First_____________ Middle___________
Address_________________________________ City______________
State_______________ Zip code____________________
Phone: ________________________ Cell phone: ________________________
Date of Birth: _____________________ (Must be at least 18 years old)
Gender: Male______ Female_________
Marital Status: Married/divorced/separated/widowed/single: _______________
Name of Spouse if married _____________________________
Do you understand and agree that any unethical, unlawful or heretical acts committed by you will automatically expel you from this Seminary?   Yes_____ No______
Are you presently employed in full-time ministry?   Yes _____ No ______
 If yes, please explain:
What is your present ministry:  Preaching_____ Pastoring ______ Counseling _______
Sunday school teacher_______ Small group leader_________ Other_______
If other please explain:
What church or ministry do you belong to?  _________________________________
How long have been serving in ministry?  _________________
Do you hold a secular Job?  
If yes, Employer __________________________ Position ____________________
Do you pay your debts in a timely Manner?  Yes_______ No _______
If no, Please explain:
Are you currently living a clean, consistent Christian Life as outlined in the scriptures?
Yes ______ No _______   (see Gal 5:22, Phil 4:8) for clarification)
Have you come to faith in Jesus Christ as your Lord and Savior?  Yes _____ No _____
Please list your education that you completed:
High school_______ some college______ college graduate_______ Doctorate______
Certificates awarded__________
Please provide copies of all certificates or Degrees awarded along with this application
Is there anything else you would like us to know about you?
Please explain:
Please provide three personal references that are not relatives:
Name_________________________ City & State________________ Phone_______________
Name_________________________ City & State________________ Phone_______________
Name_________________________ City & State________________ Phone_______________
Signature of applicant X____________________________ Date ______________
By signing this application you hereby declare that the statements given on this application are true and correct.

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