7245 College St. Lima, NY 14485
Main Phone» 585.582.1230
Admissions» 1.800.670.ELIM

Online Application
Step 1
 Personal Information
Step 2
 Education and Church Information
Step 3
 Employment and Financial Information
Step 4
 Health Information and Interests
Step 5
 Personal Statment
Married Student
International Students		 Untitled Page

* Indicates a required field

Personal Information
*Please type your full name here for ID purposes:
1.
* Last Name:
* First Name:
* Middle Initial:
Gender:
Preferred Name:
2.
Indicate Program to which you are applying.
Diploma Program: Certificate Program:
3-Year On-Campus Program Year in the Son
Draw from the Well Missions & Cultural Studies
Practical Ministry & Missions (2-yr) Church Leadership Studies
Missions & Int'l Community Health
3.
* Date you wish to enter Elim Bible Institute.

Steps in Applying:

1. The Application and Personal Statement Form must be completed solely by the Applicant, not by another person. When completed, submit the Application and Personal Statement Form, and mail the $25 non-refundable application fee to Elim Admissions. Please make payment in U.S. funds. We will send you a copy of the Statement of Financial Responsibility (page 3 of Application) to be signed. Any pertinent question left unanswered will delay the processing of your application.
2. You can download the Transcript Request Form from our site, and have your high school send an official copy of your transcripts directly to Elim Admissions. Transcripts of any post-high school academic work should also be sent to us. If you hold a four-year college degree, ask the degree-granting institution to send us an official copy of your transcript. If you are a homeschooled applicant, please contact Admissions to receive appropriate transcript forms.
3. Furnish three persons, whom you name as personal references (section 43 of this application), with copies of the Personal Reference Form provided on this website. If one of your parents is the pastor of your home church, an elder or other church officer may act as the pastoral reference for you. Please note: We expect you to indicate your choice regarding the Waiver of Access. If no choice is indicated, we will be unable to process your application.
Non-Discrimination Policy: Elim does not discriminate regarding students on the basis of race, color, and national or ethnic origin in the administration of admissions, education policies, or work scholarship programs.

Personal Data:
4. * Present Address
Address:
City:
State: Zip:
5. Permanent Address: (if different from above)
Address:
City:
State: Zip:
6.
Home Telephone Number:
7.
Daytime Telephone Number:
8.
* E-mail Address:
9.
Birthdate: (Mo./Day/Yr.)
10.
Social Security Number:
11.
Country of Birth:
If you are not a U.S. citizen please complete the "International Form."
12.
Father/Guardian's Name:
Living Deceased
Address:
City:
State: Zip:
Phone
13.
Mother/Guardian's Name:
Living Deceased
Address:
City:
State: Zip:
Phone
14.
Applicant's marital status:
* Please write a brief explanation. Divorce, itself, will not hinder your acceptance as a student.
15. If you are a married applicant, or a single applicant with dependent children please fill out the "Student Family Form."