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AGSC Online Application
General Admission
Location:
Program:
Classification: New Student
Transfer
Non-Degree Student
Visiting Student
International Student
Readmission
  Dates of last attendance:
Enrollment Semester: Fall
Spring
Summer
Enrollment Year:
Attendance: Full-time
Part-time
Housing: Seminary Housing
Commuter (Non-resident)
First Name:
Middle Name:
Last Name:
Present Street Address
City:
State:
Zip Code:
Country:
Phone (Home):
Phone (Work):
Phone (Cell):
Email:
Date of Birth:
Place of Birth:
Race/Ethnicity:
Gender:
SSN:
   
Citizenship:
Nationality:
Immigration Status:
Do you consider English
your first language?:		 Yes
No
If not, what language is?:
Have you served
in the military?:		 Yes
No
Dates of Service:
Do you expect to use
the veteran's benefits
in your training?:		 Yes
No
How did you hear about ATS/AGSC?
Who/what influenced you to apply?
What other grad schools, if any, are you considering?
Have you ever received professional counseling?
(If yes, please explain in your Christian Experience essay below)
Yes
No
Have you ever
applied to AGSC before?
Yes
No
If yes, when?:
Church Information
Name of church you currently attend:
Denomination:
Church Street Address
City:
State:
Zip Code:
Church Phone #:
How long have you attended?:
Name of Pastor:
Church Contact Person:
Are you a member?: Yes
No
Have you confessed Jesus Christ as your Savior and Lord?
Yes
No
Marital Status
Marital Status: Single
Married
Widowed
Divorced
Separated
If separated, please
explain the situation:
Maiden Name:
If married, spouse name:
Number of Children
Is your spouse in agreement with your enrolling in AGSC?
Yes
No
Will your spouse be
enrolling at AGSC?:		 Yes
No
If yes: Full-time
Part-time
Audit
Educational Background
List ALL academic institutions you have attended since high school. You are responsible for having official transcripts sent directly from each institution to the Office of Admissions. Please Note: A preliminary admission decision may be made on the basis of the work you have completed. However, you must have a final transcript showing the conferral of your degree sent to AGSC before your initial enrollment.
Previous Institutions Attended
Name of
Institution		 State/
Country		 Major/
Specialization		 Dates
Attended		 Diploma or
Degree
List memberships held in honorary and/or professional organizations:
List significant work experience which may relate to your graduate training:
What was your grade point average at the time of your college graduation?
Christian Experience
Please type a Christian Experience Statement in 1-2 pages, using the two questions below as a guideline. Please include your name, address, phone number, social security number, program you are applying for at the top of your essay. E-mail this document to admissions.ats@nyack.edu or mail it to Alliance Graduate School of Counseling, 350 N. Highland Ave, Nyack, NY 10960.
  1. Have you accepted Jesus Christ as your personal Savior? If yes, please state your conversion Experience, fundamentals of your personal faith and present pattern of personal growth as a Christian.
  2. Present a personal biography including a discussion of significant events and influences which have helped develop you present values and approach to life. What is God's call upon your life? How do you see Alliance Theological Seminary or Alliance Graduate School of Counseling fitting into God's call on your life? What do you visualize your ministry looking like five years after graduation? Include any additional information you would like to mention if you were talking to us personally about your calling and ministry goals.
Calling to Counseling
Please type short responses to the following questions Please include your name, address, phone number, social security number, program you are applying for at the top of your responses. E-mail this document to admissions.agsc@nyack.edu or mail it to Alliance Graduate School of Counseling, 350 N. Highland Ave, Nyack, NY 10960.

1. Why do you want to become a professional counselor?

2. What kind of calling for counseling ministry has God given to you?

3. What attributes/personal qualities describe you that you feel will make you an effective therapist?

4. How do you need to grow as a person in order to be a competent counselor?

5. Have others regularly sought you out for counsel or affirmed that they think you should consider becoming a counselor?
References
Please note: Do not give names of relatives as references. If your pastor is a relative, give the name of a leader in your church. School officials, employers, church leaders, teachers, and business people are preferred.

We will not contact your references directly unless you request us to do so. Please print out the reference forms from the Admissions Materials page once you have submitted your application for admission.
Pastor Reference
Name and Title:
Work Phone:
Home Phone:
Email:
Academic/Employer Reference
Name and Title:
Work Phone:
Home Phone:
Email:
Character Reference
Name and Title:
Work Phone:
Home Phone:
Email:
Emergency Contact
Name and Relation:
Work Phone:
Home Phone:
Email:
Address:
Lifestyle Agreements and Statements
We believe that the Bible is the authority for doctrine and living and that personal purity and piety of personal life should be the goal of each Christian. Men and women who aspire to Christian leadership must develop standards and values, which are rooted in the Word of God. ATS/AGSC students often form groups for mutual support and spiritual growth. They associate with a local church for worship and service. ATS/AGSC seeks candidates for admission whose life-style and personal demeanor commend them to ministry.
Family Education Rights and Privacy Act Statement:
Statement of Faith:
Standard of Conduct:
   YES, I have read and will abide by the ATS/AGSC conduct and lifestyle guidelines.
   YES, my spouse agrees to abide by the same guidelines (Disregard if not married.)
Pressing the "Submit" button constitutes a signature. By submitting this form you confirm that the above information is correct to the best of your knowledge.
Notice of Nondiscriminatory Policy: Alliance Theological Seminary does not discriminate on the basis of race, color, national and ethnic origin, age, sex, or handicap in admission, participation, or employment in campus programs or activities. The programs are operated in compliance with Title IX of the Education Amendments of 1972, Section 506 of the Rehabilitation Act of 1973, Title VI of the Civil Rights Acts of 1964, and all other relevant statutes and regulations.
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350 North Highland Ave. Nyack, NY 10960 | 845.353.2020
335 Broadway/93 Worth St. 10th Floor New York, NY 10013 | 212.625.0500