The American Institute of Theology

Office of Admissions
P.O. Box 1021
Harrison, Arkansas 72602



Please print these pages and type or print in space provided. All information received by the Institute will be held in strict confidence.

NAME (Mr., Mrs., Miss) __________________________________________________

MAIDEN / FORMER NAME (If Any) _______________________________________

ADDRESS ______________________________________________________________

CITY_____________________________ STATE________________ ZIP___________

PHONE NUMBER _______________________________________________________

EMAIL ADDRESS _______________________________________________________

DATE OF BIRTH ________________________________________________________

MARITAL STATUS: Single Married Divorced Widowed

RACIAL-ETHNIC HERITAGE (English; German; Irish; Scottish; etc. -- Specify all categories that apply) ________________________________________________________________________


 SCHOOL LAST ATTENDED _______________________________________________

If not a high school graduate, have you completed an equivalency program (GED)?
Yes No

LIST DEGREE(S) and CERTIFICATES EARNED ______________________________

CHURCH AFFILIATION ___________________________________________________

OCCUPATION ____________________________________________________________

HOBBIES and INTERESTS _________________________________________________


ASSOCIATIONS You Belong To _____________________________________________


How did you hear of A.I.T. ? _________________________________________________

What will you do with your increased knowledge of the Holy Scriptures? _____________


You May indicate here any additional goals, strengths, weaknesses, achievements, or other comments you have _______________________________________________________________________



I am enrolling as a Student and paying for the course in installments ($68.00 for registration and $11.00 per lesson).

I am enrolling as a Student and paying for the course in advance ($200.00). The extra supplemental books are included at no additional charge.

I would like my lessons sent Priority Mail ($5.00 per lesson, $60.00 total)

[Extra postage to cover costs will also be added for foreign students]

I am participating as a Non-Student; Please send the Bible Course as a Reference Work ($75.00 without extras). $100.00 with extras.

Please send the following educational materials for which I'm enclosing $________:


I'm making a donation of $_________ to help promote the Christian educational goals of the Institute.

Total Amount Enclosed $___________ Cash Check Money Order Silver
Other ___________

I certify that the information given is complete and accurate to the best of my knowledge. I understand that giving false information is grounds for denial of admission, or immediate suspension if enrolled.

Signature of Applicant _________________________________ Date ______________

Please attach a photo of yourself. (Optional)