Registration Application - Please Print
Kingdom Theological Seminary, Inc.
20 Mount Olive Cemetery Lane N. W. Kirby, Mississippi 39661
Phone: 601-951-4167
President: Dr. Steven Harrison
Dean: Dr. Ricky O’ Quinn Dean: Dr. Brenda Noach Dean: Dr. Carolyn Coleman Dean: Dr. Ray Coleman Dean: Dr. Phillip Hamilton Dean: Pastor Augustas Jones Dean: Pastor Caliph Ndemo Dean: Dr. Samson Olasupo Dean: Pastor: Christopher Pope Dean: Antoine Eakin Dean: Dr. Tracy Cusic Dean: Dr. Sadie Wilson
REGISTRATION APPLICATION - PLEASE PRINT
Name:
Date:
Address: City: State: Zip:
Date of Birth:
Home Phone: Cell Phone:
Majors Offered Please Check One
Theology [ ]
Divinity [ ]
Christian Counseling [ ]
Religious Education [ ]
CLASSIFICATION BELOW - PLEASE CHECK ONE
Bachelor 1ST Semester [ ] Bachelor 2ND Semester [ ]
Bachelor 3RD Semester [ ] Bachelor 4TH Semester [ ]
Master 1ST Semester [ ] Master 2ND Semester [ ]
Master 3RD Semester [ ] Master 4TH Semester [ ]
Doctoral 1ST Semester [ ] Doctoral 2ND Semester [ ]
Doctoral 3RD Semester [ ] Doctoral 4TH Semester [ ]
TUITION AND FEES
Fees Assessed: $ Fees Paid: $
Fees Owed: $ Balance: $
Office of Finance________________________