On-line Application for the honorary Degree of a Doctorate in Theology

Last Name		First Name
Address1
Address2
City
State/Province and Country
Zip
Home Telephone		E-mail
Business/Work/Church Affiliation		FAX Number

Years of higher education: Years

If any, years of other theological training: Years

Years of pastoral experience in church related work: Years

Please briefly describe the purpose of your spiritual goals:

Please list at least two references, including phone numbers:

If any, please list all previous degrees earned:

Please list your current church affiliation:

Have you ever been convicted of a crime:

Please list total number of years of pastoral experience:

Please list project experience (such as designing pastoral plans, starting a Mission, publishing, etc.):

If applicable, please list total years of experience in human services:

Please list your Date of Birth, Place of Birth, Social Security Number (or foreign equivalent):

Years of experience in all secular jobs: Years

At which church or employment positions did you stay for the longest time (list two top jobs with dates and company name):

Are you seeking incardination into a diocese or are you mainly interested in obtaining this Doctoral Degree? (Please give details)

Which Degree would you like to obtain? (choose from list below)

Title	Postnomial	Fee
Doctor of Divinity	D.D.	$1000
Doctor of Ministry	D. Min.	$2000
Doctor of Sacred Theology	Th. D. or S.T.D.	$3000
Spiritual Doctor or Doctor of Spirituality	S.D.	$4000