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Application Form Distance New

The document is a student application form for Leadstar Theological College's distance education programs, requiring submission by a specified deadline along with necessary documents and photographs. It outlines various programs available, personal information required from applicants, and details regarding the school leaving examination. Additionally, it includes an agreement section where applicants certify the truthfulness of their information and acknowledge the consequences of providing false information.

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0% found this document useful (0 votes)
6 views3 pages

Application Form Distance New

The document is a student application form for Leadstar Theological College's distance education programs, requiring submission by a specified deadline along with necessary documents and photographs. It outlines various programs available, personal information required from applicants, and details regarding the school leaving examination. Additionally, it includes an agreement section where applicants certify the truthfulness of their information and acknowledge the consequences of providing false information.

Uploaded by

tesfa
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

1

Attach two
LEADSTAR THEOLOGICAL COLLEGE Recent
OFFICE OF THE REGISTRAR Passport Size
STUDENT APPLICATION FORM Photographs
DISTANCE EDUCATION
Graduate/Under Graduate Program
This application form must be submitted to the Office of the Registrar on or before the application date deadline. The
form must be completed, signed and accompanied with original and photocopies of the necessary documents, two
recent photographs (3 x 4) and bank deposit slip. Applicants should collect their original documents after the
documents have been cross checked with the photocopies submitted.
 Failure to give the required information may disqualify your application.
 The application fee is non-refundable.
 Use “” to check the boxes.
1. Year of Admission: ________________ Center: _________________ (to be filled by the Center Coordinator)
2. Program: Doctor of Ministry  Graduate (MA) Undergraduate (BTh ) Diploma
3. Preferred Field of Study
Please choose one of the following fields of study currently available at the Leadstar Theological College.

Diploma
Theology and Pastoral Studies

 Undergraduate Program Bachelor of Theology ([Link])

Concentration Area in
Biblical Theology Church Ministry
World Mission Pastoral Counseling
Christian Leadership Family Education and Therapy
Community Development Youth and Child Ministry

Language (for undergraduate program):  English  Amharic  Oromiffa

 Post Graduate Program (MA)


Masters of Theology Masters of Art in Pastoral Counseling
Masters of Art in Leadership Masters of Art in Community Development
Language English Amharic Oromiffa

 Doctor of Ministry
Mission
- Leadership Community development

LTC Distance Education P.O. Box 2033/1250, Addis Ababa


2

Homiletics
4. Personal Information
5.1. Full Name:
In English: ______________________/____________________________/______________________________
Applicant’s Name Father’s Name Grand Father’s Name

በአማርኛ: ______________________/_____________________________/______________________________
ስም የአባት ስም የአያት ስም
5.2. Sex:  Male  Female
5.3. Date of Birth
______/_________/_________ ______/___________/________
In E.C. [DD MM YEAR] G.C. [DD MM YEAR]

5.4. Contact Address

Mobile/Cell Phone: ___________________/______ _______________ Office Telephone: _______________________

7. School Leaving Examination [ESLCE/ EGSEC] Details


Name of school leaving certificate examination taken: ESLCE  EGSEC 
* Write your five best results for Ethiopian School Leaving Certificate Examination [ESLCE] and seven best results for Ethiopia
General Secondary Examination Certificate [EGSEC] including English and Mathematics.
S. No. Subject Years taken Grade Registration Number
1 ENGLISH
2 MATHEMATICS
3
4
5
6
7
Grade Point Average [GPA]
If other, please specify name of the school leaving Examination:
_________________________

8. Agreement
I hereby certify that all information given on this application form is true. I am for any. I am personally responsible and
aware of the College’s action against me including Dismissal at any time of my study at the college, if the information has
been given is false and the documents submitted are forged documents. I am quite aware that I cannot make any claim of
reimbursement of whatever fee paid in case of measures leading to my suspension or dismissal from the College I also
pledge to observe and abide to all rules and regulations of the College including those of my department.

Applicant’s Name: ________________________________ Signature: _________________

Date of application: ___________/_________/___________

LTC Distance Education P.O. Box 2033/1250, Addis Ababa


3

[DD MM YEAR]

LTC Distance Education P.O. Box 2033/1250, Addis Ababa

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