Institute Classes

http://www.ministerioscristianos.org/cvba/default.html

Central Valley Baptist Association 2831 N. Berkeley Ave, Turlock, CA  95382 (209)667.2903

1.      Complete all items on application, copy onto Word document

2.      Mail the completed application to: CVICS APPLICATION, 2831 N. Berkeley Ave, Turlock, CA 95382, or scan and e-mail it to rdearls@liberty.edu

Personal Information Please print in ink or type all information 

Name:  Mr. Mrs. Miss (circle one) ____________________________________________

Birth Date: _____________ 

Mailing Address: ______________________________e-mail address: _______________

Phone contact info: _____________ home  _________________ cell

References

Please list the complete names and e-mail (home addresses if no e-mail) of three references in the space provided below.  Do not use family.  Forms will be sent to these individuals. 

Pastor _____________________________________________________________

Friend or associate ___________________________________________________________

Friend or associate ___________________________________________________________

Church Recommendation

The church supports and approves of this applicant taking classes through the CVICS.

Church name: ____________________________________  Date:  ____________

Signature of Pastor: _________________________

Academic Background

Circle highest level of education:

9     10    11    12    College:   1    2    3    4    (major area?)_______________________________

Grad/post-grad (concentration/school??)____________________________________________

CVICS Website