Arkansas Institute of Holy Land Studies
9700 Hwy. 107
Sherwood, AR 72120
General Information: (*Please print or type legibly)
Please include a recent photograph for your AIHLS file.
Home Phone: _____________________ Work Phone:________________
Date of Birth:______________________Sex: [ ] Female [ ] Male
Marital Status: [ ] Married [ ] Separated [ ] Divorced [ ] Single
Church Affiliation: (Local)________________________________________
Are you Employed? [ ] No [ ] Yes
Citizenship: [ ] USA [ ] Other, Name of Country______________________
If other, are you a permanent resident of the United States? [ ] Yes [ ] No
List other relatives who are presently attending AIHLS:_________________
List chronologically high school (or GED), all colleges, universities and/or technical schools previously attended:
High School (Name and Address):_________________________________________
College(s) Attended Name and Address:___________________________________
Number of Credits earned______________
Have you already taken the AIHLS Entrance Evaluation Examination? [ ] Yes [ ] No
Have you previously attended or taken any courses through AIHLS? [ ] Yes [ ] No
What classification are you interested in pursuing? [Check all that apply!]
[ ] Full Time Student [ ] Resident Student [ ] Auditing Student
[ ] Part Time Student for Credit [ ] Bachelor Certification
[ ] Master's Certification [ ] Correspondence Student [ ] Satellite Student
THE $25 APPLICATION FEE MUST ACCOMPANY THIS FORM!
Please list your choice(s) of courses here:
In order to have
the correspondence materials sent out to you as soon as possible,
please enclose a check or money order to cover the cost of the
courses you've selected and the application fee.
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If you prefer to make payment by use of one of these cards, please fill out the information below:
Please circle one: VISA DISCOVER MASTERCARD AMERICAN EXPRESS
Name as shown on card: _________________________________________
Please include three references from: (1) Someone who knows about your work performance; (2) Someone who knows about your academic performance; (3) Someone who knows you personally.
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