RESTORATION THEOLOGICAL SEMINARY (RTS)

APPLICATION FOR ADMISSION

Date of Application ______

“A Commitment of Excellence”

Name of Applicant Please circle (Apostle, Dr., Pastor, Rev., Minister or Lay Person)

______

(Last) (Mr., Mrs., Ms.) (First) (MI)

PERMANENT ADDRESS

______

Street Address and or Apartment Number

______

City State Zip/Postal Code

______(______)

County

Email Address

( ____ ) ______( ____ ) ______( ____ ) ______

Home Number Work Number Cell Number

What is your hometown? City ______State ______

Date of Birth ______Male _____ Female ______Last four numbers of Social Security______

Please check the program/status for which you are applying:

Degree Programs or Dual Degree Programs for Admission

 Associate Degree  Bachelor’s Degree  Master Degree  Doctorate Degree  Certificate

Please check the semester for which you are applying: Spring 20___ Summer 20___ Fall 20___ Winter 20___

Do you plan to enroll:  Full-time (12 or more credit hours per semester) Part-time (under 12 credit hours per semester)

Please check and list site if you are applying to take courses via distance learning: 

I ______, hereby request application to Restoration Theological Seminary in obedience to God's call upon my life. I hereby declare I will fulfill His "Calling" upon my life, to complete all studies as directed by the Lord Jesus Christ and the representatives of RTS. My purpose is to enter the harvest fields as a laborer for the Gospel Ministry of Jesus Christ through the field of study that He has chosen for me.

CHURCH AFFILIATION

Full name of denomination: ______

Present local church ______Location: City ______State ______

Number of years active in this church ______in ministry ______

Status in your denomination:  Ordained  Layperson

 Licensed on ______Ordained on ______

Pastor's Name: ______( ____ ) ______

Phone Number

IN CASE OF EMERGENCY

Contact Person ______Relationship: ______Home Number: ______

Page 1 of 6

* = Campus Available Courses

** = Distant Learning Available Courses

Bible Institutions usually offer several degrees within a seminary program or a theological department, including Christian ministry, youth ministry, Christian counseling, Religious and Theological studies, Bible studies and more. At RTS our Degree Program promotes the synthesis of academic knowledge, biblical perspective with a Christian worldview in order that there might be a maturing of spirituality, intellectual, social and a physical value-driven behavior.
We encourage students to engage in a major field of study in career-focused disciplines built on a solid foundation and within our liberal arts courses they are designed to encourage students to become moral leaders who are seminary qualified to spread the Word of God throughout the nation and set a responsible Christian example through their lifestyle and vocation.

GED or High School diploma required for all degrees
Associate / * / Christian Education
---- / Pastoral Ministry
* / Religious Education - Theological Studies
* / Life Coaching
* / Pastoral Care and Specialized Ministries GBOE Board Certified as Pastoral Counselor)
Bachelor Degree / * / Christian Education
---- / Pastoral Ministry
** / Religious Education - Theological Studies
* / Life Coaching
* / Pastoral Care and Specialized Ministries GBOE Board Certified as Pastoral Counselor)
Masters Degree / * / Christian Education – Teaching & Learning
* / Divinity -Professional Ministries
--- / Pastoral Ministry
** / Religious Education - Theological Studies
** / Life Coaching
** / Pastoral Care and Specialized Ministries GBOE Board Certified as Christian Counselor and Therapist)
* / Pastoral Care and Specialized Ministries NCCA Board Certified as Pastoral Counselor)
Doctorate Degree
* / Christian Education – Teaching & Learning
* / Divinity – Professional Ministries
Pastoral Ministry
* / Religious Education - Theological Studies
* / Life Coaching
** / Pastoral Care and Specialized Ministries GBOE Board Certified as Christian Counselor and Therapist)
** / Pastoral Care and Specialized Ministries NCCA Board Certified as Clinical Pastoral Counselor - Advanced)

Page 2 of 6

“The National Christian Counselors Association” is an educational and training organization for Christian Counselors.

“N.C.C.A.’s main purpose is to provide quality training for pastors and Christians who feel God’s call to counsel. NCCA’s training results in credentials that the community (Christian and non-Christian) will recognize.” RTS is recognized as one of the qualified institution certified to prepare students for NCCA Certification. ” The N.C.C.A. requires all who are certified or licensed by its

Licensing Board of Examiners to:

·  Be credentialed ministers (ordained, licensed or commissioned) whose goal is to evangelize and ease the emotional pain and suffering of humanity).

·  Prove their service under the authority of a legally organized local church, a national church organization or a

501 (c) (3) non-profit ministry.

·  Complete specialized training provided by the N.C.C.A.

·  Complete the minimum requirements for continuing education and annual license renewal.

·  Uphold N.C.C.A.‘s Code of Ethical Standards.”

Phase I the student will receive a Certificate after the completion of (5) courses of studies. The certificate will be Temperament counseling. Phase II each candidate will complete ( 3 ) additional courses and the student will receive a License Pastoral Counselor Certificate if the student holds a Bachelor’s degree and or if the student holds a Master’s will receive License Clinical Pastoral counselor certificate and for a Doctorate will receive a License Clinical Pastoral Counselor advance certified Certificate. RTS is excited to partner with NCCA in the training of Christian Counselors.

Certificate Programs / * / Certified Pastoral Counselor
* / Certified Temperament Counselor
* / Life Coaching
* / Temperament Counseling (Requirement for & Certified by NCCA)

Courses below are for those who previously completed a Certificate or Degree and have been board certified by NCCA

You are require to complete Continuing Education Courses (you may choose from the list below)

Or SKIP THIS SECTION

Faith-Based Courses for Advanced Certification by NCCA for Doctorate students

Candidates desiring License and 2nd Doctorate must complete only the four (4) advanced courses

Candidates desiring their first doctorate must choose 2 sections from the List of Faith-Based courses for Advanced Certification:

Your choices are:…

Integrated Marriage and Family Therapy

Child and Adolescent Therapy

Substance Abuse and Addiction Therapy

Sexual Therapy

Death and Grief Therapy

Crisis and Abuse Therapy

Domestic Violence and Intervention Therapy

Group Therapy

All candidates desiring NCCA Certification are required to have current ministerial credentials in order to be credentialed as a pastoral counselor by the National Christian Counselors Association. To be ordained or commissioned requires an additional course which is the written responses to a 500 question open book Equivalency Exam on the Bible (Old and New Testament – KJV).

Page 3 of 6

VOCATIONAL & WORKING HISTORY:

Please list your vocational and working history beginning with your most recent first, then back in years

EMPLOYER'S NAME: ______

EMPLOYER'S ADDRESS: ______

______

City State Zipcode

Date Began: ______Date Ended: ______

PLEASE DESCRIBE POSITION & TYPE (S) OF WORK PERFORMED: ______

______

EMPLOYER'S NAME: ______

EMPLOYER'S ADDRESS: ______

______

City State Zipcode

Date Began: ______Date Ended: ______

PLEASE DESCRIBE POSITION & TYPE (S) OF WORK PERFORMED: ______

______

EMPLOYER'S NAME: ______

EMPLOYER'S ADDRESS: ______

______

City State Zipcode

Date Began: ______Date Ended: ______

PLEASE DESCRIBE POSITION & TYPE (S) OF WORK PERFORMED: ______

______

EMPLOYER'S NAME: ______

EMPLOYER'S ADDRESS: ______

______

City State Zipcode

Date Began: ______Date Ended: ______

PLEASE DESCRIBE POSITION & TYPE (S) OF WORK PERFORMED: ______

______

Page 4 of 6

RESTORATION THEOLOGICAL SEMINARY (RTS)

EDUCATION HISTORY: Please list your educational history, starting first with your high school attendance, then any vocational, college/university, Bible College/Seminary studies completed.

NAME OF SCHOOL
CITY & STATE / YEARS ATTENDED
(______,- ______) / DEGREE EARNED
(Diploma, GED, AA, BA
MA, Ph.D., Th.D) / AREA
OF STUDY

SEMINARS & CEU HISTORY: Please list any seminars or Continuing Education Programs you may have

attended starting with the most recent first, then going back . . . use additional paper if necessary.

NAME OF SEMINAR or TRAINING PROGRAM
CITY & STATE / DATES ATTENDED
(______-______) / CERTIFICATE EARNED
,19_ ,19_) EARNED / NUMBER OF
C.E.U.'S EARNED

MILITARY HISTORY:

BRANCH OF SERVICE: ______YEARS OF SERVICE: ____-_____ TOTAL YEARS SERVED ____

COMMISSION UPON DISCHARGE: ______STATUS OF DISCHARGE______

POSITION & DUTIES (Military Occupational Specialty; MOS):

______

______

Office of Medical / Disability

Appropriate Academic accommodation requests must be made in writing at the beginning of each semester. Reasonable accommodations are a shared responsibility among the student. RTS has made a commitment to work with you.

 Medical concerns: ______

______

______

Page 5 of 6

I ______, hereby state that all of the information listed on this application is true and accurate as unto the Lord as my witness. I hereby grant permission to Restoration Theological Seminary to verify all of the information listed above. I further agree to and understand that any and all "Earned" Life Credit Hours, Educational Credit Hours, and Ministry Credit Hours based upon this application are granted at the discretion of RTS. I hereby agree and understand that I will complete all course requirements as unto the Lord Jesus Christ in the spirit of excellence, and I will comply with all Seminary Policies and Financial Commitments in pursuit of academic excellence in the Word of God.

I ______, hereby further understand that all of the courses and degrees of RTS are of an ecclesiastical nature and, whether granted or conferred, are in the restricted area of religion with the special purpose of preparing persons to work in the area of religion whether Educational, Ministerial, or Counseling and our courses depending upon your College or University of choice may be accepted with their academic guidelines however, our overall curriculum is NOT designed to be used in most general academic circles.

Application Reminders:

Check List …

Application fee of $50.00

Autobiographical Essay

 Three Letters of Recommendation: ministerial, academic, business

Endorsement from a major official of my Church / Denomination

Official and complete transcript of all schools, college, university, and seminary records

 Six page application read and filled out

Six page application read and filled out

 Checked the deadlines?

Signed and sent the following to the appropriate people

SIGNATURE

I ______, certify that the foregoing information is correct to the best of my knowledge. I understand that withholding information or giving false information constitutes prima facie (Latin meaning upon first sight) for denial of admission.

______

SIGNATURE OF APPLICANT DATE

Return to: Office of Admission and Recruitment

It is the policy of Restoration Theological Seminary (RTS) not to discriminate on the basis of race, color, nationality, ethnic origin, sex, or disability in its admission policies, educational programs, and activities.

For Office Use Only Fee Received: Amt ______Date ______By ______

Revised Application 10-15-12

Page 6 of 6