Application For Admission

Thank you for your interest in becoming a student in the Kingdom Covenant Leadership Institute's (KCLI) Online School.

Use this application form to enroll in the KCLI's Online School. Please complete all fields as indicated. Failure to complete the required fields or provide information requested may result in your application being delayed or denied.


You will be provided with a PayPal payment screen after submitting your application.


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Non-Refundable Application Fee / Annual Renewal Fee: $50 USD
Title:
First Name: * This Field is required
Last Name: * This Field is required
Mailing Address: * This Field is required
City: * This Field is required
State/Province: * This Field is required
Postal/Zip Code: * This Field is required
Country: * This Field is required
Email: * This Field is required
Confirm Email: * This Field is required
Home Tel: * This Field is required
Business Tel:
Mobile:
Non-Refundable Application Fee:
Annual Renewal Fee:
Existing KCLI Student:
Date of Birth (mm/dd/yyyy):
Employment/Occupation:
How did you hear about KCLI?: * This Field is required
Affiliate Director Name:
High School Graduate (check here):
Affiliate KCLI Campus (choose one):
Describe your Ministry and/or Leadership Experience:
First Name: * This Field is required
Last Name: * This Field is required
Username: * This Field is required
E-mail: * This Field is required
Password: * This Field is required
Verify Password: * This Field is required
  Accept Terms and Conditions
Your Login ID/Student ID and password will be provided to you once your application has been accepted. You will receive this information via email.
* This Field is required This Field is required |

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