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* Required Fields
First Name: *
Last Name: *
Address: *
City: *
State: *
Zip: * (55555)
Email: *
Home Phone: * (1-555-555-5555)
Work Phone: (1-555-555-5555)
Birth Date: * (mm/dd/yyyy)
Emergency Contact: *
Emergency Phone: * (1-555-555-5555)
Emergency Relation: *
Program * Diploma of Biblical Studies
  Diploma of Biblical Studies w/Concentration
    Please Choose a Concentration:
  • Emphasis in Pastoral Ministry
  • Emphasis in Biblical Counseling
  • Emphasis in General Church Ministry
  • Emphasis in Children's, Youth, and Christian Education ministries
  • Emphasis in Missions
Are you a member of this church? *
If no, what church?
How did you find out about CrossRoads?
Do you know for sure that you will go to heaven when you die? *
  Very Sure
  Not sure, but I want to be
If you marked Very Sure, what do you base this on?
Do you have a high school diploma or its equivalency? *
(If yes, a copy of your diploma must be provided if taking courses for credit.)
Have you previously completed a college English course? *
(If yes, a copy of your transcript must be provided if taking courses for credit.)
What is your aim in attending CrossRoads Bible Institute? *
  Prepare for full-time ministry
  Become a better servant in the church
  Simply to grow in the grace and knowledge of the Word
By submitting this application form I am indicating that I am in full agreement with the doctrinal statement of CrossRoads Bible Institute, and if I am accepted as a student, I agree to abide by the policies set forth in the catalog of the Institute. CrossRoads Bible Institute is a ministry of CrossRoads Baptist Church.

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