1Basic Info

2Emergency Contact Info

3Statistical Questionnaire

4Hazing Waiver

5Liability Waiver

6Honor Code Pledge

Basic Info
Full Name*
First Last
Email Address*
Enter Email Confirm Email
Birth Date*
Cell Phone*
Northpoint will use your cell phone number to send you important updates including but not limited to parking bans, lockdown alerts, and other
Cell Phone Carrier*

Our system requires us to know your cell phone carrier in order to send messages to your phone.
*Northpoint Bible College does not charge for calls or text messages, nor is Northpoint Bible College responsible for any applicable charges from the recipient's phone carrier.
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Student ID Photo (optional)
Accepted file types: jpg, jpeg, png, Max. file size: 2 MB.
Please upload a 2" X 2" square photo that has a resolution of at least 300dpi (600dpi is preferred). Maximum file size is 2MB, and the photo must be either .jpg, .jpeg, or .png format. The photo must have a white or neutral background and show the student's entire face without obstructions (i.e. sunglasses, hats, etc). Click here for a free online Photo ID Maker.

Emergency Contact (optional)
Name of Emergency Contact
First Last
Relationship
Phone Number
Email
Do you have any medical conditions?
- Yes
- No
Please list any medical conditions you have
Are you on any medications?
- Yes
- No
Please list any medications you are taking
Emergency Medical Authorization
This medical emergency form must be filled out by all students. (If you are under 18 years of age, your parent or guardian must fill out this section).

The purpose of this form is to authorize Northpoint Bible College to provide emergency treatment for the students on campus who become ill or injured during the school year. You can either authorize or deny such emergency treatment by completing this form.
*
- I give Northpoint Bible College permission to act on my behalf in the event of an emergency. I consent to any treatment deemed necessary by the appropriate licensed physician, dentist, or emergency personnel.
- I do not give Northpoint Bible College permission to act on my behalf in the event of an emergency.
Signature of Acceptance*
Signature of Denial*
Date*
MM slash DD slash YYYY

Hazing Waiver
*
- I hereby acknowledge that I have received a copy of the Massachusetts hazing statute, and I understand and agree to comply with its provisions.
Signature*
Date*
MM slash DD slash YYYY

Liability Waiver
*
- I hereby acknowledge that I have received a copy of the Northpoint Bible College Liability Waiver, and I understand and agree to comply with its provisions.
Signature*
Date*
MM slash DD slash YYYY

Honor Code Pledge
*
- I hereby acknowledge that I have received a copy of the Northpoint Bible College Honor Code Pledge, and I understand and agree to comply with its provisions.
Signature*
Date*
MM slash DD slash YYYY
CAPTCHA
Name
This field is for validation purposes and should be left unchanged.

Basic Info

Emergency Contact (optional)