Sponsored by

Golden Gate Baptist Theological Seminary

CLD Center (Code and Name:)

_____________________________________

Application for Admission

Contextualized Leadership Development

Name  (Last, First, Middle)

Preferred Name                                                   Prefix:         ?ß Mr.      ?ß Mrs.     ?ß Ms.     ?ß Miss     ?ß Rev.       ?ß Pastor

Social Security # or Tax ID                                                                                             Birth Date

Address

City                                                                                                                        State                     ZIP Code                              

Daytime Phone                                  Evening Phone                                   E-mail Address

Country of Citizenship                                (If not USA, please send a copy of your visa / green-card, if possible)

Gender:       ?ß Male      ?ß Female                                    Marital Status:       ?ß Married       ?ß Single      

Spouse¡¦s Name   (Last, First, Middle)

Ethnic Origin (for statistical purposes only):    ?ß African American                  ?ß Hispanic          ?ß Caucasian

                                    ?ß Native American           ?ß Asian or Pacific Islander        ?ß Other (Please Specify)

Semester/Term you plan to begin              

?ß Fall       ?ß January       ?ß Spring     ?ß Summer       Year: ___________

Diploma               ?ß Christian Ministries (DCM) ¡V 24 units       

                                ?ß Theology (DTH) ¡V 28 additional units

                                ?ß Church Planting (DCP) ¡V 28 additional units

You must complete the DCM before beginning the DTH or DCP.  However, if you plan to complete both the ¡§DCM and DTH¡¨ or the ¡§DCM and DCP,¡¨ then check both.

What is your purpose in seeking a theological education?

High School Graduate?*                ?ß Yes    ?ß No                     Do you want to transfer credit from another school into

                                                  College Graduate?          ?ß Yes    ?ß No                     this program?     ?ß Yes    ?ß No     (if yes, attach transcript)

* (You must have graduated high school or have a GED in order to be eligible for the DTH or DCP)

Have you made previous application to GGBTS?    ?ß Yes      ?ß No                  If yes, when?

How long have you been a Christian?               

(You must have been a Christian for a minimum of one year to be accepted into CLD)

Denomination:    ?ß SBC       ?ß Other Baptist        ?ß Non-Denominational          ?ß Other (please specify)               

Current Church Membership                                                                         Pastor¡¦s Name

Church Mailing Address

How long have you been a member of your current church?

List two individuals (with addresses) whom you have known well for more than one year.  You may not list family members.

Person 1

Address

Person 2

Address

You can use an additional sheet of paper if necessary.  THIS MUST BE TRANSLATED INTO ENGLISH.

Signature                                                                                                                                             Date 

Full application must be complete by:     January Semester ¡V 1/2     Summer Semester ¡V 6/15       Spring Semester ¡V 3/15 Fall Semester ¡V 10/1   * Please turn in all materials first to your center director.  The director will forward the completed packet to GGBTS.

Due the first night of class:

o $25 Application Fee

o Application for Admissions, Form I

o Christian Conduct, Form K

o 2 Photos

Due by the Application Deadline / 4 weeks

o Church Endorsement, Form J

o Copy of High School Diploma or GED

(Only required for the DTH or DCP)

Golden Gate Baptist Theological Seminary (GGBTS) admits students of any race, color, and national or ethnic origin to all rights, privileges, programs, and activities generally accorded or made available to students at the school.  It does not discriminate on the basis of sex, race, color, national, and ethnic origin, or handicap in the administration of its educational or admissions policies, scholarship, grant, loan, or other school-administered program.  GGBTS is an Equal Education Opportunity Institution.

CLD is a special program sponsored by GGBTS.  CLD students are considered students of GGBTS, however, CLD is an unaccredited program, and coursework is pre-baccalaureate, not master¡¦s level.               

FORM I  (Updated 7/07)