New/Returning Users, CLICK HERE to setup or return to your account for this form. Creating an account will enable you to partially complete this form and return later to finish. The account you establish is only for this form. Once logged in, click "Save Partial" at the bottom of the page to save this form and return later to finish.
Emmaus Bible College
Emmaus Bible College is not currently able to admit residents of the following states into any of our courses/programs that are delivered through distance learning: AL, AR, GA, MI, MN, NV, ND, OR, UT, WY, or the District of Columbia. Please check our State Authorizations page for more details about your specific state. Click here if you would like to be notified when we are able to offer courses in your state!

Enrollment Information

What type of enrollment are you pursuing? *
At this time, Emmaus requires all degree seeking students to complete at least half of their program on campus in Dubuque, Iowa. *

Personal Information

Is this your current address? *

Effective dates of your current address:

Is this a cell phone?
Text Messaging:
Are you a U.S. Citizen or Permanent Resident? *
Is your spouse a Christian?
Are you a United States Veteran?
Do you have any immediate family members that have attended Emmaus? *
Please list any immediate family members who have attended Emmaus.
 Name:Relationship to You:Dates Attended:
Are you under the age of 18? *

Parent/Guardian Information

Is your parent/guardian's address the same as your permanent address?

Church Information

Educational Information

Are you dual-enrolled?
Have you already attended a college or university? *
List the colleges or universities you have attended (even if you did not graduate).
Please include any colleges attended while in high school. If not applicable, leave spaces blank.
Have you earned a degree from any college or university? *
Have you taken any Advanced Placement tests? *
0/255 characters
Have you previously applied to Emmaus? *
Have you submitted, or plan to submit an application to any other school or college? *
Have you taken any standardized tests? (ACT/SAT) *
Was it taken within the past two years? *

Personal Statement

Please complete the following section thoroughly and thoughtfully.
Have you accepted the Lord Jesus Christ as your personal Savior? *

Reference Information

Emmaus requires a reference from a church leader, an educator, or youth leader. Do not have a member of your family complete the reference. You may either print the reference for (to be mailed upon completion), or you may have the form emailed to your reference (to be submitted electronically).
Would you like to print the reference form, or have it emailed to your Church Leader, Youth Leader, or Educator? *


Have you ever been put on academic probation in any postsecondary school? *
0/255 characters
Have you ever dropped out of, been suspended from, or been expelled from any school? *
0/255 characters

By submitting this application, I certify that the information on this application is complete and correct, and I understand that the submission of false information is grounds for denial of my application, withdrawal of any offer of acceptance, cancellation of enrollment or any appropriate disciplinary action. I authorize the college to verify the information I have provided with all the schools I have attended. I agree to notify the proper officials of the institution of any changes in the information provided.

I am also certifying that I have read the Lifestyle Covenant of Emmaus Bible College and upon admission and subsequent enrollment to the College I will gladly adhere to its guidelines and standards. 

Powered byFormsiteReport abuse
(Page 1 / 1)
Emmaus Bible College | 2570 Asbury Rd. | Dubuque, IA 52001
ph: 800.397.BIBLE | fx: 563.588.1216 |