AGSC Online Application


1. Application Information

Application For:


Enrollment Semester:

Enrollment Year:
Graduate Housing (Nyack Only):


Dates of last attendance:

2. Degree Information

Master of Arts:

3. Personal Information

First Name:
Middle Name:
Last Name:
Maiden/Previous Name:
Date of Birth:
Ethnicity (Requested for federal reporting but optional)

Choose one or more of the following:
American Indian or Alaska Native
Black or African American
Native Hawaiian or Other Pacific Islander
Country of Citizenship:
Visa Status:

Visa Type:
If you are presently in the US please send a copy of your visa with your application.
Is English your primary language?:

Primary Language:
Have you served
in the military?:

Dates of Service:
Do you expect to use
the veteran's benefits
in your training?:

What other graduate schools, if any, are you considering?
Have you ever been dismissed from an academic Institution?

If yes, provide details:
Have you ever received professional counseling?

If yes, provide details:
List memberships held in honorary and/or professional organizations:
List significant work/volunteer experience which may relate to your graduate training:

Marital Status

Marital Status:

4. Address Information

Current Mailing Address:

Zip Code:
Phone (Home):
Phone (Work):
Phone (Cell):
Email Address:

Permanent Mailing Address: (If different)

Zip Code:

5. References

Please fill out the top section of each reference form and present to an individual who has known you for over one year and is not a relative, along with a postage paid envelope for the campus you are applying to.
Pastoral Reference:
Academic Reference:
General Reference:

6. 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
School City/State Degree Received Program Attended Graduated

7. Church Information

Church Currently Attending:
Church Street Address
Zip Code:
Church Phone #:
How long have you attended?:
Name of Pastor:
Church Contact Person:
Are you a member?:

Have you confessed Jesus Christ as your Savior and Lord?

If yes, when?:

8. Additional Information

How did you hear about NYACK/AGSC?
 Magazine/Newspaper Ad
 Radio Station
 Internet/Nyack Website
 Direct Mailing
Who/what influenced you to apply?

9. Calling to Counseling

Please type short responses to the following questions.
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?

10. Christian Experience

Please type a Christian Experience Statement in 1-2 pages, using the following two questions as a guideline. Please include your name, address, phone number, date of birth, and program for which you are applying at the top of your essay. E-mail this document to or mail it to Admissions, 1 South Boulevard, 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 Graduate School of Counseling fitting into God's call on your life? What do you visualize your ministry/profession 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.

11. 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:

I affirm that the information set forth in my application and any materials I provide pertaining to my admission and/or financial aid are true and complete. I agree that if, in the judgement of Nyack, any misrepresentation or omission has been made in this application or related materials, such misrepresentation/omission of information shall be sufficient cause for rejection prior to admission and dismissal if I am admitted as a student.
   YES, I affirm the above.
Pressing the "Submit" button constitutes a signature.
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.