Florida Baptist Convention Theological Education
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1
. Name:
Name:
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2
. Email Address:
Email Address:
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3
. Church Information:
Church Information:
Church Name:
City/Town:
State:
-- select state --
AL Alabama
AK Alaska
AS American Samoa
AZ Arizona
AR Arkansas
CA California
CO Colorado
CT Connecticut
DE Delaware
DC District of Columbia
FM Federated States of Micronesia
FL Florida
GA Georgia
GU Guam
HI Hawaii
ID Idaho
IL Illinois
IN Indiana
IA Iowa
KS Kansas
KY Kentucky
LA Louisiana
ME Maine
MH Marshall Islands
MD Maryland
MA Massachusetts
MI Michigan
MN Minnesota
MS Mississippi
MO Missouri
MT Montana
NE Nebraska
NV Nevada
NH New Hampshire
NJ New Jersey
NM New Mexico
NY New York
NC North Carolina
ND North Dakota
MP Northern Mariana Islands
OH Ohio
OK Oklahoma
OR Oregon
PW Palau
PA Pennsylvania
PR Puerto Rico
RI Rhode Island
SC South Carolina
SD South Dakota
TN Tennessee
TX Texas
UT Utah
VT Vermont
VI Virgin Islands
VA Virginia
WA Washington
WV West Virginia
WI Wisconsin
WY Wyoming
ZIP:
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4
. Number of Years at Current Location:
Number of Years at Current Location:
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5
. Number of Years in Ministry:
Number of Years in Ministry:
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6
. Gender:
Gender:
Male
Female
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7
. Ministry Status:
Ministry Status:
Ordained
Lay Person
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8
. Age Category:
Age Category:
18-29
30-39
40-49
50-59
60-69
Over age 69
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9
. Highest Education Level:
Highest Education Level:
Doctorate
Masters
Bachelor
Associate
Certificate
High School
Other (please specify)
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10
. Was your theological training (or degree) in the area of ministry in which you are currently serving?
Was your theological training (or degree) in the area of ministry in which you are currently serving?
Yes
No
Not Sure
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11
. Are you interested in enrolling in a theological education class or degree program?
Are you interested in enrolling in a theological education class or degree program?
Yes
No
Not Sure
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12
. If you are interested in enrolling in a theological education program, what is your program of interest?
If you are interested in enrolling in a theological education program, what is your program of interest?
Doctorate
Masters
Bachelor
Associate
Certificate
High School
Not Interested
Other (please specify)
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13
. If you are interested in enrolling in a theological education class, which delivery system option would you prefer?
If you are interested in enrolling in a theological education class, which delivery system option would you prefer?
On-campus
Extension Center Site
Online
Combination
Not Interested
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14
. If you are interested in enrolling in a theological education class, which language of instruction would you prefer?
If you are interested in enrolling in a theological education class, which language of instruction would you prefer?
English
Spanish
French Creole
Not Interested
Other (please specify)
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