Email
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Name
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First Name
Last Name
Phone
*
(###)
###
####
Date of birth
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MM
DD
YYYY
Gender
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Male
Female
Church
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What level of education have you completed?
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I am a current high school student
I graduated from high school
Associates Degree
Bachelors Degree
Masters Degree
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Do you have any allergies, ongoing medical conditions, or disabilities?
If yes, please elaborate here:
Why do you want to attend this residency?
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Have you committed your life to Jesus Christ as your personal Lord and Savior?
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Give a brief account of your conversion experience and what your relationship looks like with Jesus today.
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Please describe your background and family life.
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What are your greatest strengths? Weaknesses?
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Describe any hopes or expectations you have for yourself within the program. What do you see as the greatest obstacle to meeting those expectations?
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Do you have a history with any of the following?
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If you selected yes to any of the previous, please explain.
Do you have any hesitations about this residency? If so, what are they?
Self-Evaluation
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How would you assess your own abilities and character in the following areas?
I am teachable.
I can adjust to new situations.
I have a strong work ethic.
I am mature.
I have good people skills.
I am honest.
I am responsible.
I am able to persevere.
I am able to work with others.
If you would like to elaborate on any of your answers, please do so here:
References
*
Please provide three references (Pastoral, Work, and Personal). Include a reference email for each.
By writing your name below, you are declaring that you have been completely honest in your application.
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