Become A COV Student

Application Form

Please specify which programme(s) that you are applying for? *

Chaplaincy Diploma

Associate Degree in Ministry Leadership

Bachelor of Arts in Ecclesiastic Leadership and Chaplaincy

Title*

Mr

Mrs

Miss

First Name*

Middle Name

Last Name*

Date of Birth*

Day

Month

Year

Age*

Country of Birth*

Citizenship*

Marital Status*

Single

Married

Widowed

Engaged

Separated

Divorced

Home Address*

Country *

Zip Code*

Email Address *

Phone: Home *

Phone: Mobile*

What languages do you speak and/or read? *

Name of Church *

Church Address *

Church Contact Number*

Pastor's Name*

Pastor’s Email: *

Disclaimer and Signature: I certify that my answers are true and complete to the best of my knowledge. If this application leads to acceptance, I understand that false or misleading information in my application may result in my release.

I agree that by selecting this box, it serves as my signature

Signature Date*

Day

Month

Year

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