*Denotes Required Field
Credit Card Type
Credit Card Number
Credit Card Expiry Date
* First Name:
* Middle Name:
* Last Name:
* Mailing Address:
* Town and Province:
* Postal Code:
( * Primary Phone: ) -
( ) -
* My primary phone number is a:
* Best way for us to stay in touch with you:
Please select an option
* If accepted, when do you plan to enroll?
* As of the first day of school, will you be 18 or older?
* Which program are you interested in pursuing?
* Marital and Family Status
Emergency Contact - preferably parent(s) or spouse:
List below the names of those you will use as references. These individuals must not be immediate family members, relatives, spouses, or boyfriends/girlfriends.
Once you have completed the application, have your references fill out the online forms or download the reference forms from our website, noting that each reference form corresponds with the specific reference categories (i.e. Pastor, Adult Christian Friend 21+).
Reference #1 - Pastor/Youth Pastor/Elder or Deacon
* First and Last Name:
( * Phone #: ) -
Reference #2 - Adult Christian Friend (Age 21 or older)
* First and Last Name:
( * Phone #: ) -
* Last high school grade completed:
* High school graduation year:
* Are you receiving, or have you received, a Government-issued Diploma or GED?
Note: You may still submit your application without your transcripts and we will acquire them at a later date.
If uploading a grade report, we will still need a copy of your final transcript showing completion of grade 12.
* Have you received any post-secondary education?
* Is your first language English?
* Do you have a learning disability?
* Has any post-secondary ever refused your application, placed you on suspension/probation, dropped you from enrollment, or given you a failing grade?
* Name of Church:
* Pastor's Name:
* When did you start attending this church?
A Bit About You
* Please share your testimony and articulate two reasons why you would like to come to PRBI in 500-750 words.
* Tell us a bit about yourself and your home life.
This is an excerpt from our Handbook that we believe God calls all believers to hold to:
Sexual activity is designed by God to be used in the context of marriage between a man and a woman. PRBI is an alcohol, drug, and tobacco/cigarette/cannabis/vape free campus. We therefore encourage students to refrain from indulging in any substance(s) that would cloud your judgement or is used for self-medication. We are to follow God’s Word and obey the governing authorities in Canada so long as they do not conflict and therefore do not associate with any activities that would compromise these standards.
* In the past year, have you struggled in any of the areas listed above?
* Have you ever been convicted of a criminal offense, other than traffic violations?
How would you describe your current relationship with God? (select all that apply)
Consistent (with devotions, etc)
Has its ups and downs
What makes you excited about potentially coming to PRBI? (select all that apply)
Maturing in my faith
Being in community with other believers
Discovering more about myself as a child of God
Making new friends
Gaining a deeper understanding of who God is
Exploring God-given gifts and passions
Gaining leadership skills
Learning to study and apply God's word biblically
How did you hear about PRBI? (select all that apply)
PRBI Recruitment Department
PRBI Event (Water Balloon Mania, eView, etc.)
* Did a student or alumni invite you for a campus visit?
* What is their name?
* Will you have all your funds with you for the first day of school each semester and commit to follow through on paying your account in full?
If you have questions about payment please email email@example.com.
How do you plan to finance your studies at PRBI? (select all that apply)
Other (Please Explain):
Please select discounts you may be eligible for (full-time students only):
One or more parents in full-time vocational ministry
I have been in full-time ministry for 6 months or more, immediately prior to attending PRBI
I am attending at the same time as one (or more) of my siblings
I am attending at the same time as my spouse
I came for an official Campus Visit/eView
I helped recruit/refer a new student who came for a campus visit and is now attending PRBI
* What is the name(s) of the student(s) you have recruited/referred?
Entrance Bursary Opportunity
If finances are still a concern for you,
click here to apply for the Jackie Whitehouse Entrance Bursary.
Please fill out the following Medical Information. SPECIAL NOTE: PRBI reserves the right to request further information from a physician regarding the contents of this medical form if deemed necessary.
Since we do not have health services on campus, it is important that you have health insurance coverage. If you do not have any type of health insurance, please apply for it before coming to PRBI.
Name any allergies you have and the treatments that accompany them.
* Are you on a special diet that is prescribed by a medical doctor?
* Please state why and what type of diet.
* Are you presently on medication?
* Please indicate the following: medication, dosage, condition treated, and how long you have been on the medication.
* Do you have any special weaknesses, abnormalities, or limitations that we should be aware of? Do any of these hinder you or prevent involvement in physical activities or school?
* In the last 5 years, have you struggled with anxiety, depression, or mental health concerns?
* Do you have physical limitations that require a special bed?
* Please explain
Dormitory Accommodations: Since we expect all single students to live in the residence, the following information will assist us in choosing a compatible roommate for you. If you have special circumstances that would necessitate living out of residence, you must apply in writing to the respective Dean for a review of your request.
Early to Bed
* Do you play Advanced Piano?
* What level?
* Are you interested in joining our drama tour team?
* Are you interested in joining our music tour team?
Dining Hall Floor Crew
Worship Media Tech
Please list any previous experience:
Note: By attending PRBI, you accept that pictures of you may be periodically posted online or used in printed materials. Should you wish to withdraw this consent once you arrive on campus, please see the Graphic Artist in person for a form.
I accept that pictures of me may be periodically posted online or used in printed materials.
Please read the PRBI Handbook before proceeding.
* I agree to the Terms listed in the Handbook above.
Please list any concerns you may have:
Our Student Life department will contact you.
After submitting this form, further application instructions will be shown. Please do not leave the page until instructions appear.
Click here to read the
full PRBI Handbook or find it on our website. Please read this before the first day of classes.