Application

Full Name

Address

Apartment #

City

State

Zip Code

Phone #

Date of Birth

Occupation

Work Email

How do you know you are Saved?

Why do you want to be trained in the skill of Evangelism?

Church Membership?

Yes

If no, why are you unchurched?

If yes, please list church name, phone, address, and Pastor

List 2 references with contact information

Are you presently a student?

Yes

If yes, where are you a student?

How did you hear about this course?

Name of person recommending you?

Additional Information or Comments

Anti-Violence Crusades
Anti-Drug Crusades
School of Evangelism
Homeless Outreaches
Gospel Tract Distributions