Briercrest Seminary Application Form

Please fill out all fields to the best of your ability.

Page 1 of 16 - Personal Information

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Course of Study

Please indicate your desired program and emphasis below.
Choose a Program
Approximate Program Start Date Approximate Program Start Date / MM / DD YYYY
Personal Information

Please fill out all required fields.
Legal First Name
Middle Name
Legal Last Name
Former Last Name (if applicable)
Preferred Name
Primary Phone Number
Alternate Phone Number
What is your preferred communication method?

What is your preferred communication method? Email Phone
Email Address

Confirm Email Address
Alternate Email Address
Mailing Address

Please provide details of your mailing address.
Street Address
Address Line 2
City
State / Province / Region

Write "n/a" if not applicable to your location.
Postal / Zip Code

Write "n/a" if not applicable to your location.
Country
Save my progress and resume later
Enter Your Email Address *

A special link to resume the form will be sent to your email address.