                         APPLICATION FOR ADMISSION
                          Pensacola Bible Institute

    To apply for admission, detach this sheet. Fill out both sides
completely-please write legibly. Enclose a $15.00 registra-
tion fee and recent photograph. Return it to the Registrar:

                    Mr. Robert W. Mitchell
                   Pensacola Bible Institute
                         P.O. Box 6235
                      Pensacola, FL 32503



1.  Name:_________________________________________________________________
          Last                      First                    Middle



2.  Sex:________         3 Date of Birth: ________________________



4.  Place of Birth: ______________________________________________



5.  Social Security Number: _________-_______________-_________



6. Next of kin: __________________________________________________
   (in case of emergency)

Address:        __________________________________________________


7. Telephone:   __________________________________________________


8. Tuition must be paid in advance when registration
   completed in person. I will pay (check one):


    Weekly _____       Monthly _______      Semester _______







9.  Signatire:______________________________         Date:______________















=================================<Page 2>==============================


                  Please fill out both sides completely.


    I am not engaged nor intend to be engaged in any form
of subversive activity against the United States of America.


    I do not use alcoholic beverages or tobacco in any form
nor do I attend mixed dances or the theater.


    I am sincere in my intent to develop my Christian
character as an example of the believer and will try to obey
my teachers and be a blessing to the Institute.

    I have read pages one and two of this application.

    1 hereby apply for admission to the Pensacola Bible In

stitute for the school year: ____________




Signature: ____________________________________  Date:___________________



Attach registration fee of $15.00


Attach a recent photo below
