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Name *
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Track
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Entering Term
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Please choose the start date that correlates with your desired track. Undecided may start at any term.
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Permanent Address
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Gender
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Male
Female
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Email *
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Date of Birth
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Phone
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Passport Number & Exp. Date
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Marital Status
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Single, Never Married
Married
Separated
Divorced
Remarried
Widowed
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Spouse’s Name (if applicable)
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High School Attended, Years, GPA
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College Attended, Years, GPA
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Degree/Major
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Other Schools or Professional Qualifications
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Skills
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Music
Language
Occupational Skill
Technology
Other
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Please describe
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Describe Your Salvation Experience
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Have You Been Baptized?
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Yes
No
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Have You Experience w/ Gifts of the Spirit? If so, please describe
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Do You Attend Church?
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Yes
No
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If Yes, Name of Church, Pastor, and Phone #
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If No, Do You Have a Spiritual Leader In Your Life?
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Have You Ever Participated In the Following:
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The World Race
Short Term Missions (1 wk-1 mo)
Missions Trip (1-11 mos)
African Vision Trip
Long Term Missions (1 yr+)
Other Missions Activity
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Describe any involvement in activities listed above
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Are you CURRENTLY:
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Involved
in criminal activity
Struggling with suicidal thoughts
Sexually active
Addicted to pornography
Addicted to alcohol
Involved in the occult
Taking medication
Have allergic reactions
Have ongoing medical issue(s)
Any other physical or mental disability (please describe)
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Please Explain Answers Above
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Do You Have Your Complete Course Fees?
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Yes
No
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If no, how are you planning to fund your support costs during the course?
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Partially by
Donations
Completely by
Donations
Work Prior to
Arrival
Work
During Course (tele-commuting)
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If Raising Funds, How Much Do You Currently Have Raised?
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Describe any ministries/activities you have participated in.
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Describe your current relationship with Christ.
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Describe your current relationship with the Holy Spirit.
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Describe your calling, passions, & future goals & what impact this training will have on them
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Reference #1: Pastor/Spiritual Leader/WR Coach (not immediate family)
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Please include contact information for all references.
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Reference #2: Employer/Associate/Teacher (not immediate family)
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Reference #3: Close Friend/Mentor
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How did you hear about us?
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From a G42 Leader
From a former graduate
Through the
World Race
From my pastor
Web search/Web ad
Printed ad or brochure
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Referrer Name
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Agreement and Release
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Check if you agree with the following statement: The information given here is accurate to the best of my knowledge. I authorize any references listed in this application to give G42 any information (including opinions) that they may have regarding my character, abilities or spiritual readiness for this program. I release all such references from any liability for furnishing either written or verbal information, opinions or evaluations to G42, provided they do so in good faith and without malice. I waive any right that I may have to inspect the information provided about me. Should my application be accepted, I agree to abide by the policies, guidelines and leadership of the program. (Your printed name below is your digital signature verifying this statement)
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Digital Signature
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Image Verification
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