Online Course Application

You do not need to be a current EBI student to take online classes. Each course will count as full credit, and can be applied towards a diploma or certificate program if you decide to apply to one of our programs in the future. A full list of our diploma and certificate programs is located here.

Note: Approval for online courses does not imply acceptance into our regular diploma or certificate programs. If you should decide to apply to one of our regular programs, you will need to satisfy all admissions requirements, including residency and internships, if applicable.

If you are a current Elim student, you do not need to submit this form. Contact the Academic Office for assistance in registering for online courses.

To begin taking online courses:

Submit this online application form.
Submit your $25 non-refundable application fee.
An Elim representative will contact you to assist with further instructions for registration and payment.

Personal Information

*First Name:

*Last Name:

*Address:

Address Continued:

*City:

*State/Prov:

*Postal/Zip Code:

Country:

Date of Birth:

*Gender:

*Daytime Phone:

*E-mail:

*Are you Married? Yes No

If yes, Spouse's Name:

*Do you have access to a computer with an internet connection? Yes No

*We strongly recommend a high-speed internet connection for video and audio. Do you have access to high-speed internet? Yes No

Education

Highest level of education

*Date of High School graduation:
(if you are still in high school, enter your expected graduation date)

Have you ever taken EBI courses?

Year/Semester Interested in:

Reference Information

We ask that all of our students maintain a connection with a local church in their area. Please list a church and pastor that we can contact as a reference.

*Church name:

*Phone:

*E-mail:

*Pastor's name:

Other Information

*Please enter a brief statement about your relationship with God and why you're interested in taking online courses through Elim Bible Institute:

How did you hear about Elim's online courses?

Additional Comments:

*Required Field † Please call 1-800-670-ELIM if you have any questions, or chat online with one of our admissions representatives.

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