Christ Community Bible Academy Application

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Please contact Matt Rouse (matt@ccclh.org) with any questions.

Please fill out the form and press the send button.

* Required information.

First Name: *

Last Name: *

Address: *

City: *

State: *

Zip Code: *

Phone Number: *

E-mail Address: *

Are you interested in the certificate or audit track? *

Certificate

Audit

Do you need financial assistance? *

Yes, partial scholarship

Yes, full scholarship

If yes, please explain your need:

Why do you want to pursue study at CCBA? *

Please list previous schools attended, degrees awarded, etc.:

Which of the following times works best for you? (check all that apply): *

Weekday evenings

Saturday mornings

Sunday mornings (Sunday school hour)