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Application Form

LeadersROAR Application Form

Legal Name *
Legal Name
Preferred Name
Preferred Name
Address *
Address
Phone *
Phone
Gender *
Date of Birth *
Date of Birth
*18-20 year olds may be considered under special recommendation
Marital Status *
For Married Applicannts
Date of Marriage
Date of Marriage
Name - Gender - Age - Living with you?
List high school, college, and other institutions of higher education you have attended. Name - City, State - Dates - Attended - Degree Earned
List employment for the past five years. Name - City, State - Dates - Employed Type of Work
Are you presently under the care of a physician for a physical condition? *
Are you presently taking any medications? *
In case of an emergency, whom should we contact? *
In case of an emergency, whom should we contact?
Address *
Address
Phone *
Phone
Pastor's Information
For Pastoral Recommendation
Pastor's Name *
Pastor's Name
Church Name *
Church Name
Contact Number *
Contact Number
Spiritual Inventory
Address *
Address
Phone *
Phone
Senior Pastor's Name *
Senior Pastor's Name
When did you accept Christ as your personal Savior? *
When did you accept Christ as your personal Savior?
Have you been baptized in water? *
Approximate Date
Approximate Date
Have you received the baptism of the Holy Spirit? *
Approximate Date
Approximate Date
Personal Assessment *
Personal Assessment
Please assess the following in yourself: (Strongly Disagrees – poor; Disagree – fair; Neutral – good; Agree – very good; Strongly Agree – Outstanding)
Spiritual maturity
Devotion to Christ
Personal integrity
Self-discipline
Willingness to serve
Willingness to learn
Interpersonal relationships
Family life
Ability to work with others
Communication skills
Leadership skills
Reliability
Physical health
Purpose, Calling and Gifts
What ministry emphasis are you choosing? *