Request Information

Please complete this form for more information about Geneva College at Center for Urban Biblical Ministry. This will enable us to provide you information on your particular area of study and/or our exciting new program, A Brighter Pittsburgh (for graduating high school seniors and post-grads ages 17-20).

We invite you to Spend an Evening with us so you can visit with staff and students and experience a class in operation. You will discover for yourself why CUBM continues to be the chosen first step for so many with higher education goals.

Please note in the “Comments” section the specific request so we can serve you better.

*First Name   
*Last Name
*Street Address
*City
*State
*Zip
*Country (if other than US)
*Email address
*Home Phone  ( )
*Other Phone   ( )

Intended Major:    Ministry       Business        Human Services

Name of High School:

Graduation Year:

Entrance Term:    Spring - January 2010     Summer - June 2010

     Fall - September 2010      Spring - January 2011

    Summer- June 2011      Fall - September 2011

How did you hear about CUBM?   Friends/Relative    Geneva College office/mailer

       Radio     Web Search      Newspaper

       H.S. Guidance Counselor/Teacher   College Fair   

       Other        If Other, please specify:

Comments: