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

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Online Application Part 2
*Please type your full name here for ID purposes:

Educational Information:
1.
 List senior high school and institutions of higher education in order of attendance, beginning with the most recent:
Name and Address
Dates Attended
Graduation Date
Degrees Earned
2.
 If you do not have a high school diploma, do you have a high school equivalency diploma (GED)?
If yes, please arrange for an official copy of your test scores to be sent to us.
If no, are you working toward receiving one?
3.
 List other colleges to which you have applied this semester, separating each one with a semicolon:

Church & Biographical Information:
4.
 Are you a minister's child? Are you a missionary's child?
5.
 For the purpose of encouraging you in your progress as an Elim student, we try to identify certain aspects of your background and experience, such as cross-cultural exposure.
Have you ever spent an extended amount of time living in another culture during your developmental years?
If so, How long? Where?
6.
 Fellowship affiliation of your home church:Elim Fellowship

Other

7.
 When were you converted?
Have you lived a consistent life since conversion?
8.
 Have you received the baptism of the Holy Spirit? If yes, when?
9.
 List the name and address of your home church and senior pastor:

Home Church
Name:
Address:
City:
State: Zip:
Phone:
Number of years attended:

Senior Pastor
Name:
Address:
City:
State: Zip:
Phone:
10.
 Have you ever been convicted of a misdemeanor or felony? If Yes, when?

Military Information:
11.
 If you are a veteran, please complete the following:
Branch of service:
Dates of service:
Highest rank:
Type of discharge:
If other, please explain:
12.
 Are you eligible for VA benefits?
If yes, please have a Certificate of Eligibility, or other proof, sent to the admissions Office.