New Application for Admission

Truth College at the Rock

1401 Calvary Road,
North Little Rock, AR 72116

Application for Admission

Personal Information

Please upload a picture

Last Name

First Name

Middle Name

Suffix

Preferred Name

Gender

Date of Birth

Social Security Number (last 4 digits):

Street

City

Zip/Postcode

State/Province

Country

Home Phone

Cell Phone

Work Phone

Ethnicity

Marital Status

Spouse's Last Name

Spouse's First Name

Spouse's Cell Phone

Parental Information

Please complete only if you are still in high school. If both parents live together, only complete the father's address information.

Father's Last Name

Father's First Name

Street

City

Zip/Postcode

State/Province

Country

Phone

Work Phone

Mother's Last Name

Mother's First Name

Street

City

Zip/Postcode

State/Province

Country

Phone

Work Phone

Emergency Contact Information

In case of an emergency, please notify the following person if parent(s)/spouse cannot be reached.

Last Name

First Name

Relationship

Street

City

State/Province

Zip Code

Country

Home Phone

Work Phone

Cell Phone

Pastor & Church Information

Please complete only if not a member of First Pentecostal Church.

Pastor's Last Name

Pastor's First Name

Pastor's Email

Street

City

State/Province

Zip Code

Country

Church's Name

Affiliation

Street

City

State/Province

Zip Code

Country

Phone

Academic Information

Are you a Calvary Academy student?

Yes No Not Selected

High School Name

Graduation Date

City

State/Province

High School GPA

SAT Date

SAT Score(Optional)

ACT Date

ACT Score (Optional)

Are you an Ollis Scholarship Recipient?

Yes No Not Selected

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Please list all colleges and universities attended or attending.

1. School Name

1. City and State

1. Date Attended

2. School Name

2. City and State

2. Date Attended

3. School Name

3. City and State

3. Date Attended

Financial Obligation Contract

I agree to accept all debts incurred from Truth College at the Rock. I realize it is my responsibility to clear any amount owed to the college within forty-five days, unless other arrangements with the Finance Office have been made before the due date. I understand that if my financial obligations are not met, I will not be eligible for re-enrollment in Truth College at the Rock.

I agree to the Financial Obligation Contract as stated above

Yes No Not Selected

Parent/Guardian's Signature

(Please sign if the financial obligations will be payed by parents.)

Date:

Applicant's Signature

(Please sign if the financial obligations will be payed by the student.)

Date:

Spiritual Information

Please briefly answer these questions with one or two sentences.

Why do want to attend Truth College at the Rock?

Please describe any church related activities in which you are presently or have been involved.

Please describe your Spiritual condition.

Have you been baptized in Jesus' Name?

Yes No Not Selected

Have you received the Holy Ghost?

Yes No Not Selected

Other than traffic violations, have you been convicted by the law or incarcerated?

Yes No Not Selected

If yes, please explain below:

Projected Major & Graduation

What major are you planning to pursue at Truth College at the Rock?

Program

Release of Grades

The Privacy Act requires Truth College at the Rock to receive a written signature from the applicant before any grades may be released to anyone other than the student.

I authorize Truth College at the Rock to release my grades to:

Name:

Relation:

Name:

Relation

Applicant's Signature:

Date:

-

If the student is still in high school, the parent(s) will receive a copy of the grades at the end of the module.

Pastoral Recommendation

If applicant is not a member of the First Pentecostal Church, please have your pastor complete the form available on our website and email it to info@go2tcr.com.

Applicant's Signature

Applicant's signature

Date:

Parent/Guardian's Signature

Date:

I have carefully reviewed this application, and to the best of my knowledge the information on this application is correct.

Enter the above code

Required