Date_____________________

Full Name___________________________________________________________
                 Last                    (Maiden)                 First                     Middle                                                                           

Address_____________________________________________________________

City/State/Zip (Postal) Code_____________________________________________

Phone (           )_______________________________________________________

EmailAddress_________________________________________________________

Employer____________________________________________________________

Occupation___________________________________________________________

Birth Date_____________________________________________ Sex:   F     M                                                                                               

Previous Education Information
                                                                                                                                          
College(s) Attended  Total Credits         Dates                  Major              Degree(s)  

					

					

Unofficial transcripts are acceptable for this evaluation. Include a detailed resume and any other information that will be helpful in determining possible Life Credit based on your professional experience. If a diploma is presented and no transcripts are available, the student must list how many semesters attended, hours per semester, and provide an overview of the material covered.

Desired Education Information

   Advanced Prophetics Institute                   M.A.                                 Ph.D.

REQUEST for TRANSCRIPT

Date of Request:______________________________________________________

ATTENTION:_________________________________________________________

School:_____________________________________________________________

Address:____________________________________________________________

City/State/Zip:_______________________________________________________

Dear Sir or Madam:

Please send the item(s) checked below to:

			The School of Prophets
			P.O. Box 2510
			Chattanooga, TN 37409
			(423) 825-6247
			www.schoolofprophets.org

  Complete transcript(s) of my academic record
  A letter of good standing

My name while attending your school______________________________________

I last attended your school_______________________   My date birth___________ 

If there is any charge for this service, please bill me at the address below.

Sincerely,

Please sign __________________________________________________________

Print your name______________________________________________________

Mailing Address ______________________________________________________

City, State, Zip/Postal Code_____________________________________________

Life Credit for duties performed

Name of Organization:                                                          Number of Years:
Positions & Duties:

Name of Organization:                                                          Number of Years:
Positions & Duties:

Life Credit in Non-College Training

Name of Course:                                                                              Date:
Provider:                                                      Location:                      Hours:
Subject and Materials Covered:

Name of Course:                                                                               Date:
Provider:                                                      Location:                       Hours:
Subject and Materials Covered:

Name of Course:                                                                               Date:
Provider:                                                      Location:                       Hours:
Subject and Materials Covered:

References

Please list adults (no relatives) who are well-acquainted with you. Any additional information you wish to include may be enclosed on a separate sheet. 

Name:                                                                          Phone: (      )

Address:

City/State/Zip:

Name:                                                                          Phone: (      )

Address:

City/State/Zip:

Name:                                                                          Phone: (      )

Address:

City/State/Zip:

STOP at this Point.  Your signature is required only after this Evaluation Form has been returned to you and you wish to enroll into the program. 

Evaluation Report (for School of Prophets office use only)
 Transcripts Received:  Official    Unofficial                       Resume Received
 Total Hours Required to Complete Degree of  MA     PhD ________________
 Thesis or Dissertation Required __________
 Number of Courses Required _________   See Attached Sheet for Specifics                                                 
 Other: ______________________________________________________
Workshop   Middle-East Trip 
Date Accepted into the Advanced Prophets Program __________________________                                                                            

ACCEPTANCE by LEARNER.  By signing below, you are enrolling as a Learner in the School of Prophets/Louisiana Baptist University Advanced Prophets program.

Signed____________________________________________  Date_____________