FEBIAS REGISTRATION FORM

        
*=required field          
           
Lastname * Given Name Middle Name      
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E-mail Address: * Telephone Nos. / Contact Nos.:        
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Present Address          
Date of Birth (mm/dd/yyyy) Age Sex: [Male Female ]      
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Place of Birth Nationality        
       
Name of   [Parents Guardian ]        
Address  
Civil Status




       

If married, do you have children?:

 [Yes No ] How many? What ages?      

If not from Manila, give name and address and nature of kinship of any relative in Manila
Denominational Background
           
Give complete mailing address of your church
           
Are you          

         
           
EDUCATIONAL ATTAINMENT:          
           
 
Name of School
Address
Year
Attended
Year
Graduated
Primary
Elementary
Hight School
College
Vocational
Others
         
(Important)
  
 
 
Have you ever been refused admission, suspended by, or dismissed from any school? [Yes No ] Explain
   
What musical ability or talents do you possess?
What skills are you proficient at?
(Ex. Computer, Steno, etc. State years of experience)
What athletics or hobbies are you most interested in?
What dialects do you speak with a measure of fluency?
What others are you familiar with?
Have you received the Lord Jesus Christ into your heart as Savior?
When?
Please indicate all Christian ministry experiences that you have had.
Do you believe God wants you to serve Him full-time?
What circumstances or facts led you to this conclusion?
How did you first become interested in F.C.B.?
To what church do you belong?
Give name and address of your Pastor
Have you read the entire New Testament? [Yes No ] Old Testament? [Yes No ]
Are you in accord with our doctrinal statement?
If so, sign the F.C.B. Statement of Faith.
Are you willing to sign and abide by the following pledge? [Yes No ]
I agree to abstain from dancing, the use of tobacco, drugs, beer and other intoxicating beverages, attendance at the theater or clubs or other questionable amusements and membership in secret societies and fraternities. I further agree to submit to those in authority, to cooperate cheerfully and willingly with the rules and regulations of the school and to abide by its policy that in the event a student is disciplined due to serious infraction of the rules, the Administration reserves the right to send him/her home without prior consultation with the parent or guardian whenever such action is deemed necessary.
 
Give the names and complete addresses of three (3) reliable references who have known you for some time:
  Name Address
Pastor
Former teacher
Personal acquaintance
 
 
MEDICAL QUESTIONAIRE:  
State your general health. Good Fair Poor  
Have you ever had any operations? If so, what? When?
What childhood diseases have you had, such as chicken pox, mumps, measles, whooping cough, others?
Have you ever had tuberculosis? [Yes No ] Have any member of your family had (or now have) tuberculosis? [Yes No ]
Have you had a chest X-Ray? [Yes No ]When? Where?
Do you have any allergies to medicines? Etc?
Do you wear eye-glasses? [Yes No ]Are you bothered by frequent headaches? [Yes No ]
Do you have frequent colds? [Yes No ]
Have you ever contracted a venereal disease? [Yes No ]
Blood Type
 
FINANCIAL QUESTIONNAIRE:
How will you be supported?