Jerusalem Seminary Application – Spring 2023

Identification Details

Salutation *

First Name *

Middle Name

Last Name *

Suffix

Preferred Name

Email Address *

Address *

Address

City

State/Province

Zip/Postal

Country

Phone *

Do not include spaces or brackets. Please include International Dialling Code e.g +1 (USA) or +972 (Israel)

Personal Details

Gender *

Marital Status *

Date of Birth *

City of Birth *

State of Birth

Country of Birth *

Identity document type *

Identity Document Number *

Nationality / Citizenship

English proficiency

Is English your native / birth language? *

Yes

What is your native / birth language? *

Are you proficient in English (Spoken, Written & Read)? *

Yes

Reference Person

Please provide the name of a person as a reference. The person:

Should not be a family member, and
Has known you for more than a year.

The reference person may be contacted by the JS Office of Admissions for more information.

Referrer's First Name *

Referrer's Last Name *

Referrer's relationship to you *

Referrer's Email *

Congregational Affiliation

Name of current congregation / fellowship where you are either a member or are in current attendance. *

Which denomination or movement is the congregation / fellowship associated with? *

How long have you been attending? *

Which congregation / fellowship did you previously attend?

Are you a licensed minister? *

Yes

Are you ordained? *

Yes

Online Course System Credentials

Have you previously enrolled as a student with Jerusalem Seminary?

Yes

Please provide your desired JS system login credentials.

Desired Username *

Between 8 - 12 alphabetical characters

Desired Password *

Eight characters minimum One lowercase letter One uppercase letter One number One special character

Between 8 - 12 alphanumeric and special characters in length

Payment Details

Coupon Code

Discount

Total Cost

Payment Method *

Credit Card

Paypal

Bank Transfer

Cardholder's First Name *

Last Name *

Credit Card *

Billing Address *

Billing Address

City

State/Province

Zip/Postal

Country

On submission of this application form you will be directed to PayPal's website to effect payment.

After submitting this form, please send an email to info@jerusalemseminary.org in order to receive our bank details for payment.
Please note: Acceptance into our courses will only be considered after payment is made.

Agreement

Jerusalem Seminary's Lifestyle Commitment.

I have read and agree with Jerusalem Seminary's Lifestyle Commitment above

Jerusalem Seminary's Statement of Faith

I have read and agree with Jerusalem Seminary's Statement of Faith above

Jerusalem Seminary's Registration Cancellation and Tuition Refund Information.

I have read and agree with Jerusalem Seminary's registration cancellation and refund policy above

By taking this course you agree that:

this course will be recorded and may appear in a public forum in order to promote the JS vision of ministry training from Jerusalem.
the material provided in Jerusalem Seminary courses will be for my use only and I will not copy, transfer or supply the material to any third party.

* For any special concerns please be in contact with the Jerusalem Seminary administration.

Jerusalem Seminary admits students without regard to race, color, sex, national or ethnic origin, disability, age, or veteran status with respect for personal dignity.

If you are human, leave this field blank.