| APPLICATION FOR ATTENDANCE IN RESIDENCE AT GATEWAY CHRISTIAN COLLEGE, VIRGINIA BEACH, VA. PLEASE COMPLETE ALL FIELDS BELOW. |
| PERSONAL INFORMATION: |
| Pressing the "Enter" or "Return" key on your keyboard will submit this form. Use the Tab key or mouse to move from box to box. |
| FAMILY INFORMATION: |
| EDUCATIONAL INFORMATION: |
| SPIRITUAL INFORMATION: |
| Pressing the "Enter" or "Return" key on your keyboard will submit this form. Use the Tab key or mouse to move from box to box. |
| PUBLIC INFORMATION: |
| REQUIRED INFORMATION: |
| AGREEMENT: I certify that the information on this application form is complete and accurate. I affirm that by submitting this application and signing my name, that if I am accepted that I will conduct myself with the consistency of faithful Christianity. |

| Virginia Beach, VA |
| Virginia Beach, VA |