Church Leadership Application Form


Please tick which course you would like to study and the mode of delivery.

Certificate in Christian Leadership (LLP)CounsellingCertificate in Christian Ministry & Leadership (Elders)

Personal Details

Support From Your Church


Physical Disability / Learning Difficulty / Health

Do you have any physical disability, learning difficulty or health problem that might affect your studies or residential needs? If so, please give details:

Emergency Contact

Academic Qualifications (For Certificate in Church Leadership & Ministry Only)

Please list details below (most recent first) of qualifications you have gained. If you have not yet gained the award, please state in the Name of institution column ’pending’.

Name of institution and address Dates of attendance (From) Dates of attendance (To) Qualification, subject name and awarding body Date of award


Please give us the names and addresses of TWO people to whom we may write (remember to ask them first). One should be your church pastor/leader, the other should be able to comment on your personal and vocational development and/or on your academic ability.
Please note, we cannot accept family members/relations as referees.

Referee 1

Referee 2

Criminal Convictions



Equal Opportunities Monitoring Information

Information on ethnicity and/or disability will not be used in reaching a decision on the outcome of your application.

Ethnic Origin

WhiteBlack/British CaribbeanBlack/British AfricanBlack (Other)Asian/British PakistaniAsian/British BangladeshiAsian/British IndianAsian/British ChineseAsian (Other)White/Black CaribbeanWhite/Black AfricanWhite/AsianOtherDo not wish to specifyNot Known

Disabilities (tick all that apply)

AutisticBlind/Visually impairedDeaf/Hearing impairedDyslexiaOther Learning DifficultyMental Health needsMobility problemsMultiple disabilitiesUnseen disabilityOther

If you selected 'Other' please specify:

Finding out about Birmingham Christian College

How did you first learn about Birmingham Christian College (please tick)?

Internet SearchChurch/PastorFriendCurrent/Former StudentPress AdvertRadio AdvertOther

If you selected 'Other' please specify:

Additional Information

If you would like to be included on our mailing list to receive information and news about the college, special events and other courses of interest please tick this box.