Request for Information

Application items are included in the information packet.

Heartland Baptist Bible College reserves the right to accept only applicants who are members of Independent Baptist churches.

To submit a request for an information/application packet, please fill out the form below and click Submit.  We will receive your information and put a packet in the mail to you. 

 First Name  Last Name  

Home Address

City  State  Zip 

Country    Foreign Country Code

Phone #   Email

Date of Birth  Country of Citizenship 

Male        Female                   Marital Status

Semester you are interested in attending:   

Program of Study Desired? 

High School Graduate?   Yes     No     GED

If you haven't graduated yet, what year in high school?   

Date of Graduation?   

Name of Independent Baptist Church you attend: 

City    State    Pastor's Name 

How did you learn about Heartland?