EmailMe Form - Vineyard Heroic Leadership Institute

Date

MM / DD / YYYY

Full Name

Prefix First Last Suffix

(As it appears on your passport)

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country

Date of birth

MM / DD / YYYY

Email

Phone

### - ### - ####

Cell phone

### - ### - ####

Passport Number

Marital status

If married, is your spouse supportive of you joining HLI? Please explain:

Local Church

Senior Pastor

Youth Pastor (if part of a youth group)

Please check which HLI site you are applying for.

Mile High Vineyard, Denver, CO

Duluth Vineyard, Duluth, MN

Pathway Vineyard, Lewiston, ME

Based on the website and other information why did you choose this site?

Please check which area
of "focus" you would like to do? (2-4 hrs/week as a specialty)

Education Information: please list high school(s), year of graduation or GED, college experience (if applicable), and extracurricular activities (church involvement, community/volunteer activities, any short-term missions, music/theatre, athletics, etc.). Please list work experience as well.

Ministry Training: please indicate any you have received, church/trainer, & date completed

How long have you been involved at your local church and in what capacities?

Parent's Name

First Last

Parent's Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country

Parent's phone

### - ### - ####

Parent's Email

Parent's Name

First Last

Parent's Address (if different than above)

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country

Parent's Email

Parent's Phone

### - ### - ####

How do your parents feel about you attending HLI?

Have you ever been found responsible for a disciplinary violation at an educational institution you have attended from 9th grade (or the international equivalent) forward that resulted in your suspension, removal, dismissal, or expulsion from the institution?

Yes

No

Have you ever been convicted of a misdemeanor, felony, or other crime?

Yes

No

If you answered "yes" to either or both questions, please give the approximate date of each incident & explain the circumstances.

What else would you like us to know about you?

What is your favorite movie?

What is your favorite snack food?

What is your favorite healthy food?

What is your favorite worship song?

What is would you do on a Saturday night?

Financial Status:
How do you plan to pay for you tuition?

Will you have the total amount by the required dates?

Will you have your own vehicle available for local transportation during the school year?

yes

no

If no, are you prepared financially to assist another student with gas & upkeep of their vehicle in order to carpool?

Yes

No

List any debts, loans, payments that you will have during the school

How do you intend to make those payments during the school year?

Application Essay: Please type a 3-5 paragraph response to the following questions:
1. Why do you want to join the Heroic Leadership Institute?
2. How did you begin your journey with God? Where are you at right now?

Upload a current picture of yourself:)