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Admissions

Application for Admission

Complete the form below to apply to Legacy Biblical Counseling Institute. All fields are required unless marked optional.

Personal Information

Full Name

Email Address

Phone Number

Date of Birth

Address

Gender

Current Marital Status

Social Security Number

Your information is kept confidential and used for enrollment purposes only.

Present Employment

Educational Background

Highest Education Level

High School Name

High School City and State

College Level / Degrees Earned (if applicable)

Faith & Church

Have you trusted Jesus Christ as your Savior?

Are you a church member?

Church Name and Address

Pastor's Name

Signature

By typing your full name below, you affirm that all information provided in this application is true and accurate to the best of your knowledge.

Signature (type full name)

Date

Legacy's student body comes from many local churches. It is our policy that all programs offered shall be equally available to all persons without regard to race, age, sex, or handicap.

Training Christian Counselors

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Contact Us

Location

4520 Old Hollow Road

Kernersville, NC 27284

Email

[email protected]

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