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Kanana Fou Theological Seminary
2 Kanana Fou Street | P.O. Box 456 | Pago Pago, AS 96799
Ph: (684) 699-2273/4322 | Fax: (684) 699-5479
Website: www.kftseminary.org | Email: kfouseminary@yahoo.com
Application Fee: USD$25.00
Full Name: __________________________________________ Social Security Number: ___________________
Last First Middle
Date of Birth: ____________________ Place of Birth: ____________________ Nationality: __________________
Address: ____________________________________________________________ Telephone: ( ) _____ ______
Street City State Zip Code
Program of Study:
[ ] Diploma of Theology [ ] Bachelor of Divinity (BD)
Note: BD Program: Mark only one area of interest. ! Ministry and Personality ! Bible and Theology
Marital Status (Check only one): !Married ! Divorced ! Widowed ! Single
Do you have children? ! Yes ! No If your child (or children) is accompanying you, please list the names
and ages below:
Name: ______________________________ Age: ________ ! Male ! Female
Name: ______________________________ Age: ________ ! Male ! Female
Name: ______________________________ Age: ________ ! Male ! Female
Educational Background:
Name of High School: ___________________________________ Year Graduated: ________
Name of College or University ____________________________ Year Graduated _________ Degree ________
Name of College or University ____________________________ Year Graduated _________ Degree ________
Trade/Technical School __________________________________ Year Graduated _________ Degree ________
Employment: Please list your employment experience in the last five (5) years beginning with the most recent.
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Special Trades/Skills:
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Medical Background:
Do you have any medical conditions that require special attention? [ ] Yes [ ] No
If yes, please explain: ___________________________________________________________________________
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Note: Studying and other related activities at Kanana Fou may be stressful, and it is required that you provide us
with a physical evaluation from a physician stating your current health condition. The physical evaluation may be
submitted together with this application form or prior to the Elder’s Orientation (Ta’utinoga)
Name of Pastor: ___________________ Sub-district (Pulega): ______________ Elder: ____________________
Person to contact in case of emergency: ______________________________ Relationship to you: ______________
Address: _____________________________________________________________________________________
STREET CITY, STATE, ZIP DATE
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CONTACT INFORMATION: Phone E-Mail
I certify that the abovementioned information is correct and true to the best of my knowledge, and that I wish to be
enrolled in Kanana Fou Theological Seminary for the full course of studies.
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APPLICANT’S SIGNATURE DATE
I, the undersigned Elder in-charge of this sub-district (pulega), do hereby declare that the applicant stated above is of
good moral character and conduct, and that I recommend his/her application for enrollment in the seminary subject
to his/her passing of the Written Entrance Examination.
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ELDER’S SIGNATURE SUB-DISTRICT (PULEGA) DATE
PLEASE NOTE: The signature of the Sub-District (Pulega) Elder is required for all candidates who are affiliated
with the CCCAS in the United States, Australia, New Zealand, and American Samoa.
REFERENCE FORM (Page 1)
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Recommendation for Admission
TO THE APPLICANT
Please complete the section below and give this form to the person whom you have asked to write a letter on your
behalf. The completed and signed form and recommendation should be sent directly to the Office of Admission.
This form can also be sent to the recommender via email through the online application system, which is preferred
by the KFTS admissions office.
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APPLICANT NAME (LAST, FIRST, MIDDLE)
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CURRENT MAILING ADDRESS (STREET OR P.O. BOX ADDRESS)
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CITY, STATE, ZIP TELEPHONE (HOME, CELL, OR OTHER)
DEGREE SOUGHT
[ ] Bachelor of Divinity (BD)
• [ ] Ministry and Personality
• [ ] Bible and Theology
[ ] Diploma in Theology
• [ ] Pastoral Ministry
TYPE OF RECOMMENDATION
[ ] Academic Reference [ ] Pastoral Reference [ ] Ecclesiastical Reference [ ] Employment Reference
PRIVACY
The Family Education and Privacy Act of 1974 gives you the right to inspect letters of recommendation written in
support of applications for admissions. The act also permits you to waive your right to see letters of
recommendation.
[ ] I waive my right to inspect this letter. [ ] I do not waive my right to inspect this letter.
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SIGNATURE OF APPLICANT DATE
Please Note: This letter will not be considered unless dated and signed by the applicant.
REFERENCE FORM (Page 2)
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Recommendation for Admission
TO THE RECOMMENDER
The Admission Committee appreciates receiving your Letter of Recommendation for the applicant (named on page
1 of this form). The information you provide is considered an important part of the application process. It is in the
best interest of the prospective student as well as the school to make your comment both candid and substantial.
Your insights will be of value in judging the applicant’s qualification for admission as well as assisting him/her to
plan an educational program responsive to both professional and personal growth needs.
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RECOMMENDER’S NAME
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ADDRESS (STREE, CITY, STATE, ZIP)
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OCCUPATION
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WORK TELEPHONE HOME/CELL TELEPHONE
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SIGNATURE OF RECOMMENDER DATE
INSTRUCTIONS FOR THE RECOMMENDER
In your letter of recommendation please respond to the questions below. Please send this form along with your
signed letter of recommendation directly to the Office of Admission.
• How long, how closely, and under what circumstances have you known the applicant?
• If you are a professor/instructor, please evaluate the applicant’s academic capacity and past academic
performance as well the individual’s ability to engage in undergraduate and/or professional studies.
• How would you evaluate the applicant’s ability to succeed in an undergraduate academic environment?
• How open and flexible is the applicant to differing viewpoints and perspectives on religious, social, and
intellectual issues?
• What leadership abilities has this applicant illustrated? What is his/her potential for leadership in the
future?
• Describe the applicant as a person: strengths, limitations, usual way of relating to others, and ability to cope
with stress and conflict.
• What, if anything, can you tell us about the applicant’s religious experience, the maturity of his/her spiritual
development, and needs for spiritual growth?
• What is the applicant’s formal relationship and involvement with the church/denomination?
• How would you describe the applicant’s awareness and response to social concerns and the role of religious
communities in the world?
Return this form along with your signed Letter of Recommendation to:
Kanana Fou Theological Seminary | Office of Admission | P.O. Box 456 | Kanana Fou, AS 96799
PERSONAL STATEMENT (Page 3)
You may attach additional pages if needed for your answers.
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Briefly state your reason(s) for choosing Kanana Fou Theological Seminary?
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What programs or events that really influenced your decision to enroll at Kanana Fou?
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How would you describe yourself? What are your strengths and limitations?
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If graduate from Kanana Fou, in what way would you use your theological training?
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What is your opinion and response to social issues and the role of religious communities in the world?
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Who are the most influential persons in your life? How have they inspired your decision and the person
you are now?
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STUDENT SIGNATURE DATE
