APPLICATION FOR ADMISSION Pensacola Bible Institute To apply for admission, detach this sheet. Fill out both sides completely-please write legibly. Enclose a $15.00 registra- tion fee and recent photograph. Return it to the Registrar: Mr. Robert W. Mitchell Pensacola Bible Institute P.O. Box 6235 Pensacola, FL 32503 1. Name:_________________________________________________________________ Last First Middle 2. Sex:________ 3 Date of Birth: ________________________ 4. Place of Birth: ______________________________________________ 5. Social Security Number: _________-_______________-_________ 6. Next of kin: __________________________________________________ (in case of emergency) Address: __________________________________________________ 7. Telephone: __________________________________________________ 8. Tuition must be paid in advance when registration completed in person. I will pay (check one): Weekly _____ Monthly _______ Semester _______ 9. Signatire:______________________________ Date:______________ =============================================================== Please fill out both sides completely. I am not engaged nor intend to be engaged in any form of subversive activity against the United States of America. I do not use alcoholic beverages or tobacco in any form nor do I attend mixed dances or the theater. I am sincere in my intent to develop my Christian character as an example of the believer and will try to obey my teachers and be a blessing to the Institute. I have read pages one and two of this application. 1 hereby apply for admission to the Pensacola Bible In stitute for the school year: ____________ Signature: ____________________________________ Date:___________________ Attach registration fee of $15.00 Attach a recent photo below