Lagos Campus
Use this online form if you are a Level 1 Prospective Student applying to the Lagos Campus. Accurately fill-out the form. All blanks must be completed for this application to be processed. Type DNA (Does Not Apply) for blanks that are NOT applicable to you.

Please note you must have make the required application fee before filling this form, follow this link to pay now - https://rhemanigeria.com/tuition-payment/

If you have any questions please email: admin@rhemanigeria.com

Title *
Firstname *
Your answer
Middlename
Your answer
Surname *
Your answer
Gender *
Your contact address or Permanent home address *
Your contact address or permanent home address
Your answer
City *
Your answer
Country *
Your answer
Mobile *
Your answer
Email Address *
Your answer
Passport/Driver's License
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Nationality *
Marital Status *
How many Children do you have? Give their names and ages:
Your answer
Are you Born-Again (saved) as understood in Romans 10:8-10? *
How long have you been born again? *
Your answer
Are you baptized in the Holy Spirit with the evidence of speaking in tongues as in Acts 2:4? *
Payment Reference *
Have you paid your application fee? Enter your teller number or transaction id here.
Your answer
CHURCH AFFILIATION AND REFERENCES
What church do you currently attend? *
Name of Church
Your answer
Church Address
Your answer
Name of Pastor:
Your answer
Pastor's Mobile Number
Your answer
How long have you been attending this church?
Your answer
Do you attend regularly?
What Church activities have you been involved in, and how long?
Your answer
If you are not currently involved with local church, explain why below:
Your answer
Pastor/Minister Referee (Name, Tel., & Email) *
Enter their Fullname, Telephone number and Email Address
Your answer
Personal Referee (Name, Tel., & Email) *
Enter their Fullname, Telephone number & Email Address
Your answer
Employer (Work) Referee *
Enter their Fullname, Telephone & Email Address
Your answer
Do you believe the Bible is the inspired Word of God and the only infallible guide in matters pertaining to conduct and doctrine? *
Do you believe in the Holy Trinity – that our God is one, but manifested in three persons: the Father, the Son and the Holy Spirit?
Do you believe in the deity of the Lord Jesus Christ, that He is God made flesh, and He is the only mediator between God and man?
HAVING READ THE RHEMA NIGERIA STATEMENT OF FAITH, DO YOU AGREE WITH ITS CONTENT?
HEALTH/MEDICAL
If you have any disabilities that would require special facilities, please state what they would be. Also give the full name and address of a contact person in case of emergencies.
Disabilities/Medical Condition
Your answer
Fullname
Your answer
Address/Telephone
Your answer
I, the undersigned, grant full and complete permission to Rhema Nigeria, its employees or designates, or any related or consulting physician to render or give emergency medical aid, care, treatment, or assistance that could or would be deemed required or necessary. This consent I give freely and voluntarily, fully knowing and understanding all the above and its effect upon me.
I hereby state that all the information contained on this application is correct and true. If Rhema Nigeria is notified that any of the information contained on the application is false, it will be grounds for immediate dismissal.
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