Section A - Personal Information

Name :

Family name/Surname :

Address :

Postal :

Home Tel :

Office Tel :

Fax :

Mobile :

Email :

NRIC/Passport Number :

Country of Birth :

Date of Birth :

Gender :  F M

Are you a Thai citizen? :  Yes No
If not, citizen of

1st language
2nd language

Marital status :
 Single Married Divorced Remarried Widowed

How did you know about Kingdom Glory Leadership Institute?

If applicable, who referred you to Kingdom Glory Leadership Institute?

What are your objectives of attending Kingdom Glory Leadership Institute?

Section B - Church Affiliation

Name of Church :

Denomination :

Church Address :

Years Attend :

Ministry Position Held :

Plan & Payment

Choose Study Plan

Reference

Current or most recent pastor

Name of pastor :

Church Name :

Church Tel :

Church Address :

Postal Code :

Country :

Comments or Questions

Photo Upload : (file size max 1MB)

Declaration

 I confirm that all of the information furnished above is true and complete.
 I agree to abide by the rules of the school if my application is accepted.