Personal Info

PrefixPlease select onePastorBishopApostleMr.Mrs.Dr.Ms.Rev.Chancellor








SuffixPlease select oneIIIIIIIVVPhDJr

Country *United State of AmericaAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia-HerzegovinaBotswanaBouvet IslandBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoDemocratic Republic of the (Zaire)Republic ofCook IslandsCosta RicaCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupe (French)Guam (USA)GuatemalaGuineaGuinea BissauGuyanaHaitiHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyIvory Coast (Cote D`Ivoire)JamaicaJapanJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartinique (French)MauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew Caledonia (French)New ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandPolandPolynesia (French)PortugalPuerto RicoQatarReunionRomaniaRussiaRwandaSaint HelenaSaint Kitts and NevisSaint LuciaSaint Pierre and MiquelonSaint Vincent and GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-Leste (East Timor)TogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVenezuelaVietnamVirgin IslandsWallis and Futuna IslandsYemenZambiaZimbabwe

Sex *
Please select oneMaleFemale


Date of Birth
Month *JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember
Day *12345678910111213141516171819202122232425262728293031
Year *20152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924192319221921192019191918191719161915

Church Affiliation and References

Name of Church



Senior Pastor



How long have you pastored or attended this church?

Have you previously submitted an application to Destiny College? *

Your Spiritual Journey

Are you a Chrstian *

Name of Denomination

Educational History

Education *
Please select one6789101112GED / Vocational / Technical


College *
Please select oneStill in collegeAssociateBachelorMasterSpecialistDoctorate

List all higher education institutions attended

Referral

Were you referred by one of our team members to become a part of Destiny College? *

Who referred you?
NobodyDr. Vivian RodgersDr. Elin RiegelPastor Chris UgohReverend Daniel CheahPastor Micheal SpencerPastors Marco & Cindy JacobsDr. Shandrey & Ps Reyhana ThumbranDr. Len & Dr. Veni AndrewDr. Randlee & Ps Natasha ReddyPs Adrian & Ps Nerissa NaidooDr. Dave WilliamsDr. Robb ThompsonDr. John BurpeeDominic GalatiEdward TuroseEric ScottKerry EsserNelson Rivera

Statement of Truth

I understand all items submitted to Destiny College International as part of the application process become the permanent property of Destiny College International and will not be returned. This application will be held in confidence. Only those persons with a need to know will review it. I grant Destiny College International and its leadership permission to verify the information provided on this application. I hereby state that all the information contained on this application is correct and true. If Destiny College International is notified that any of the information contained on the application is false it will be grounds for immediate cancellation of application. Any dues/fees associated with filling this application are non-refundable.

Please select one *

I agree with paying the $25 Administration Fee *