The Seminary of Saint Albert the Great
P.O. Box 5375
Chico, CA 95927

Full Name:   ______________________________________________________

                       (Last)                                 (First)                             (Middle)

Address:       _____________________________________________________

                     _____________________________________________________

                     _____________________________________________________

Age  ............   Date of Birth .....................        Married / Single / Divorced?  ................

Telephone Number .......................................    E-mail .......................................................

Current occupation?............................................................................................................

Current Church Affiliation?  ...............................................................................................

State the Degree program you wish to apply for: ............................................................

Ordination - If interested in preparation for Ordination - check here.  ........................

Previous Education:

  Name of College, Seminary, Course, etc.             Dates Attended                   Degree

_______________________________________________________________________

_______________________________________________________________________

Financial Information: Degree/Program and Fees: ______________________________________

Payment attached ________ Or,   I prefer to make a deposit of _$100.00 and installments of $65.00/mo.

I hereby apply for registration as a student with The Seminary of Saint Albert the Great. I attest that I am a Christian and accept the guidance of Jesus in my life. I agree to abide by the rules and regulations of the Seminary.

Date: _________        Student Signature: __________________________________