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Fomu kujiunga degree tpbc
- 1. Tazengwa Pentecostal Bible College P. O. Box 107 Nzega, Tanzania Phone: 0755 638 792 Email: tpbcfpct@hotmail.com APPLICATION FOR ENROLLMENT DEGREE PROGRAM APPLICANT’S PERSONAL INFORMATION Name of applicant………………………………………………………………………………….. Date of birth ……………………………………………………………………………………….. Country of birth ………………………………..Country of citizenship…………………………... Gender : Male ……………………. Female …………………………. Marital status: Single ………Engaged………Married……….Widowed……….Divorced………. If married, Spouse’s full name…………………………………………………………………….. Postal address ……………………………………. City /Town ………………………………….. Country…………………………………………………………………………………………….. Phone number(s)…………………………………………………………………………………… Email address…………………………………................................................................................. Cell / Mobile number………………………………………………………………………………. What Church are you a member of? ………………………………………………………………. ……………………………………………………………………………………………………… Are you in a church ministry? ………………If yes, briefly say something about your ministry and your current position…………………………………………………………………………... …………………………………………………………………………………………………… …………………………………………………………………………………………………… …… ……………………………………………………………………………………………………… …………………………………………………………………………………………………… …………………………………………………………………………………………………… …………………………………………………………………………………………………… ……… 1
- 2. EDUCATIONAL INFORMATION Secular Education STD VII……….FORM IV…………. FORM VI …………..COLLEGE……………………… UNIVERSITY……………………….. Bible / Theological Education Bible school / college? Yes ………….. No……………..Where / Which Bible School or Bible College? …………………………………………………………………………………………… ……………………………………………………………………………………………………… SPONSORSHIP Who will be your sponsor during your studies at Tazengwa Pentecostal Bible College (TPBC)? ............................................................................................................................................ ............... ……………………………………………………………………………………………………… Address…………………………………………………………………………………………….. I, ………………………………………………………………….. certify that will be responsible for taking care of all the applicant fees/costs during his / her studies at TPBC. Signature of the Sponsor …………………………………………Date ……………………… FAMILY CARE Who will take care of your family during your studies at TPBC? .……………………………… ……………………………………………………………………………………………………. Address…………………………………………………………………………………………… Relationship………………………………………………………………………………………. I, ……………………………………………………………………certify that will be responsible for the applicant’s family during his / her studies at TPBC. Signature of the Family Member ……………………………………… Date …………………… Name of the applicant………………………………………………………………………….. Signature of the applicant……………………………………………………………………… FEES 2
- 3. FPCT STUDENTS NON – FPCT STUDENTS Tshs. 650,000/= per semester Tshs. 650,000/= per semester NOTE: The above fees are subject to review / change from time to time. Tazengwa Pentecostal Bible College P. O. Box 107 Nzega, Tanzania Phone: 0755 638 792 Email: tpbcfpct@hotmail.com PASTOR’S (OR CHURCH ELDER’S) RECOMMENDATION FORM Applicant’s name…………………………………………………………………………………... The person named above has applied for admission to Tazengwa Pentecostal Bible College. We believe that you as his/ her Pastor / Church Elder know him/her well and work closely with him / her. Please evaluate the applicant by filling this form as complete as possible. Your sincerity is absolutely essential. Return this form directly to the college using the address given above. Keep your recommendation confidential. Thank you for your help. 1. How long have you known the applicant (years and months)…………………………….. ……………………………………………………………………………………………… 2. In what capacity have you know the applicant? ................................................................... …………………………………………………………………………………………… …………………………………………………………………………………………… …………………………………………………………………………………………… ……… 3. What ministerial credential does he / she presently hold? .................................................... ……………………………………………………………………………………………… ……………………………………………………………………………………………… 4. Has he / she ever been a cause of trouble or disciplined in the local church, district or national church level? Yes............... No………… If yes, explain: …………………………………………………………………………………………… …………………………………………………………………………………………… …………………………………………………………………………………………… …………………………………………………………………………………………… 3
- 4. …………………………………………………………………………………………… …………… 5. Is he / she presently married? Yes …………No…………Not sure……………………….. 6. Has he /she separated from a spouse or divorced? Yes.....................No............................. 7. Describe his / her personality. Tick where applicable: Not sure Poor Fair Good Very good General health Ability to handle stress and conflicts Ability to relate to others Ability to handle money honestly Relationship with opposite sex 8. Do you recommend him / her for enrollment at Tazengwa Pentecostal Bible College? Yes, with my highest recommendation …….. No, with my sincere remarks…….. If No, please explain why. ………………………………………………………………………... ……………………………………………………………………………………………… ……………………………………………………………………………………………… ……………………………………………………………………………………………… Your Name…………………………………………………………………………………. Title / Position……………………………………………………………………………… Address…………………………………………………………………………………….. Phone number(s) ………………………………………………………………………….. E-mail address (if you have) ……………………………………………………………… Signature ……………………………………………… Date ……………………………. STAMP HERE 4
- 5. Tazengwa Pentecostal Bible College P. O. Box 107 Nzega, Tanzania Phone: 0755 638 792 Email: tpbcfpct@hotmail.com MEDICAL REPORT Dear Medical Doctor, The bearer of this medical report form has applied for admission to Tazengwa Pentecostal Bible College (P.O. Box 107, Nzega, Tabora – Tanzania). All applicants are required to have this report completed by a medical doctor before being considered for admission. Would you, please make a thorough examination and fill this form. If you have any additional comments, please write on the piece of paper and attach it to this report. Thank you for your assistance. 1. Does the applicant have any evidence of the following: a. Heart trouble………………………………………………………………………………. b. Allergies ………………………………………………………………………………….. c. Chest infection …………………………………………………………………………….. d. Vision impairment ………………………………………………………………………… e. Any physical disability ……………………………………………………………………. 2. Is there any type of food the applicant should abstain from, on medical basis? …………………………………………………………………………………………………….. …………………………………………………………………………………………………….. 3. Is there anything which might prevent the applicant from carrying a full load of studies and physical activities at our College? ……………………………………………………………. ………………………………………………………………………………………………… ………………………………………………………………………………………………… 4. Is the applicant pregnant? ………………….If yes, how many weeks pregnant is she? ............................................................................................................................................. ...... 5. General comments and advise from the Medical Doctor: …………………………………….. ………………………………………………………………………………………………….. ………………………………………………………………………………………………….. …………………………………………………………………………………………………. Name of the Medical Doctor……………………………………………………………………… Title or position…………………………………………………………………………………… 5
- 6. Address…………………………………………………………………………………………… Phone number(s)………………………………….……………………………………………… Signature and date…………………………………………………………………………………. STAMP 6
- 7. Address…………………………………………………………………………………………… Phone number(s)………………………………….……………………………………………… Signature and date…………………………………………………………………………………. STAMP 6