Step 1 of 5 - Registration 20% Email* Enter Email Confirm Email Today's Date* Birthdate* Age* Name* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone*Years Saved* Church's Name*Pastor's Name* First Last Church's Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Church's Phone*Pastor's Email* High School* First Last Address* City State / Province / Region ZIP / Postal Code Graduation Date* Have you previously attended college?*Choose oneYesNoCollege Name*Years attended*Are you looking to enroll at any other college?*Choose oneYesNoHave you ever been expelled or suspended from an institute of learning on a high school or collegiate level?*Choose oneYesNoHave you ever been denied admission to an institute of learning on a high school or collegiate level?*Choose oneYesNoHow did you hear about us? I hereby certify that this application is true and complete with no omissions in any area. I also understand that any untrue statement will make me subject to immediate dismissal from Independent Baptist Online College. Upon matriculation, I agree to comply with the doctrines, rules, regulations and financial obligations of the institution and to maintain standards of conduct in accordance with the aims and objectives of Independent Baptist Online College.Do you agree to the above terms?*Choose oneYesNoChoose a username*Choose a password* Enter Password Confirm Password Strength indicator NameThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.