EmailMe Form - New Student Form

Name *

Prefix First Last Suffix

Email *

Track *

Track 1

Bible

Shepherd Staff

Worship

Mailing Address *

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

Gender *

Male

Female

Date of Birth

MM / DD / YYYY

Marital Status *

Are you currently living with someone who is not your spouse? *

Yes

No

If yes, please explain:

What is your highest level of education completed? *

Are you able to take part in classroom activites such as writing, reading, presenting, unassisted listening to instructors, unassisted independent study, sitting for extended periods of time and etc. as a student? *

Yes

No

If no, please explain:

We comply with the ADA and consider reasonable accommodation measures that may be necessary for applicants to be successful in the essential functions of the classroom.

Have you ever been convicted of a felony, child abuse, or a crime involving actual or attempted sexual molestation of a minor? *

Yes

No

If yes, please explain:

Have you accepted Jesus as Lord and Savior? *

Yes

No

How long ago? *

5 or more years

3-5 years

1-2 years

Less than 1 year

Have you received the Baptism of the Holy Spirit? *

Yes

No

Are you a member at WOL? *

Yes

No

Are you an employee at WOL? *

Yes

No

Are you in a small group? *

Yes

No

How did you hear about the SOM? *

Ministry Information

Ministry Goal: *

Name of Church you regularly attend: *

Pastor: *

How long have you attended? *

If you are not currently attending a church regularly, briefly explain:

Which church ministries are you currently involved in, and how long have you been serving?

Release with Signature

TRUTH: I understand that all the information contained in this application is correct and true. I understand that all items submitted to Water of Life Community Church School of Ministry as part of the application process becomes permanent property of WOL School of Ministry and will not be returned or copied for applicants use.

MEDICAL: I, the undersigned, do hereby state that on the date indicated, I do grant full and complete permission to Water of Life Community Church School of Ministry, its employees or designate, or any related or consulting physician to render or give emergency medical aid, care, treatment, or assistance that could or would be deemed required or necessary. This consent I give freely and voluntarily, fully knowing and understanding all the above and its relation to and effect upon me.

MARKETING: By signing below, I hereby authorize Water of Life Community Church to use any and all likenesses, photos, and/or videos of me and my person in any future publications or materials.

Do you agree with the terms and conditions? *

Yes, I agree.

Signature *

Date *

MM / DD / YYYY