APPLICATION Full legal name Name you are called by Relationship Status Social Media Handle (platform in parentheses) Email Address Date T Shirt Size T Shirt SizeX SmallSmallMediumLargeX Large2X Large3X Large Ring Size Ring Size33.544.555.566.577.588.599.51010.51111.51212.51313.5 Address City State Zip Birthday (mm/dd/yy) How did you hear about RDS? Father's Name Phone Number Occupation Accepted Christ Address Mother's Name Phone Number Accepted Christ Occupation Address Guardian's Name Phone Number Accepted Christ Occupation Address Parent Info Parent InfoMarriedSeperatedDivorced Father's Info Father's InfoAliveDeceased Mother's Info Mother's InfoAliveDeceased Who do you currently live with? Who do you currently live with?Both ParentsFatherMotherOther Who do you currently live with? How many siblings do you have? Siblings (list all brothers and sisters from oldest to youngest)) Describe your family life Do you have health insurance? Who is your provider? Emergency contact Emergency contact phone number Physician's name Phone On a scale from 1-10, 1 being very unhealthy, 10 being in the best shape of my life, how would you rate yourself? On a scale from 1-10, 1 being very unhealthy, 10 being in the best shape of my life, how would you rate yourself? 12345678910 Are you currently receiving medical treatment? Describe any physical problems or allergies that require medication or physical care List all physical limitations/all disabilities (including physical, mental, or learning) Do you exercise? If so, how much per week? If not, why not? Do you presently attend church? Do you presently attend church?YesNo Name of the church you are attending How long have you attended this church? How many times a week do you attend church? Are you a member of this church? Are you a member of this church?YesNo Church denomination Name of lead pastor Name of youth pastor Church Address Church phone number Did your family attend church together? Did your family attend church together?YesNo Were your parents a good spiritual role model for you? Were your parents a good spiritual role model for you?YesNo When did you accept Christ? (mm/yy) Have you ever been baptized in water? Have you ever been baptized in water?YesNo When were you first born again? (mm/yy) When were you first born again? (mm/yy)YesNo Do you feel a possible call to ministry? Do you feel a possible call to ministry?YesNo Please explain List the different ministries you have been or are currently involved in Have you ever had an Acts 2:4 experience? (not required for acceptance) High school (select last completed year) High school (select last completed year)Did not attend high school1234 Name of high school High school phone number City/state Year graduated GPA College (select last completed year) College (select last completed year)Did not attend college1234 Name of college Job status Job statusEmployedUnemployed Job title Employer Length of employment How do you plan to pay for tuition? Person responsible for paying your tuition Address of person (if not already above) Are you able to pay fully at the start of the year? Are you able to pay fully at the start of the year?YesNo Do you have debt? Do you have debt?YesNo Will this prevent you from paying tuition? Will this prevent you from paying tuition? YesNo Are you presently responsible for the care/finances of any children? Are you presently responsible for the care/finances of any children?YesNo Briefly tell us your testimony What is your definition of a servant? Define your idea of ministry What are some qualities you feel are necessary to be a spiritual leader? What do you plan on doing after attending Refuge Discipleship School? Submit
