Satellite Campus Individual Application

Campus Admin Name *

First

Last

Email *

Phone Number *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Gender *

Have you used tobacco in the last 12 months? *

Yes
No

If yes, please explain:

Have you consumed alcohol in the last 12 months? *

Yes
No

If yes, please explain:

Have you used any illegal drugs in the last 12 months? *

Yes
No

If yes, please explain:

Have you been involved in pornography in the last 12 months? *

Yes
No

If yes, how often and how recently?

If yes, where are you in your process of pursuing and obtaining freedom?

Have you been sexually active in the last 2 years? Singles (with anyone) marrieds (with anyone other than your spouse.) We define sexually active as including intercourse, oral sex, foreplay, and sexting. *

Yes
No

If yes, please explain:

Have you struggled with homosexual behavior or same sex attraction in the last 5 years? *

Yes
No

If yes, please explain where you are in your process to pursue freedom in this.

Have you exhibited any self-destructive behavior or habitual problems within the last 5 years? (i.e. eating disorder, cutting, compulsive lying) *

Yes
No

Have you ever been arrested? *

Yes
No

If “yes” please give a brief explanation of when and why.

Have you ever been in the occult, witchcraft, or cults? *

Yes
No

Spiritual History

When did you accept Jesus Christ as your Lord and Savior? *

Have you been baptized in the Holy Spirit with evidence of speaking in tongues? *

Please explain your experience

Are you directly connected to your pastor/and or leaders at your home church? *

Yes
No

Have you separated from a church/ministry in the last 2 years? If so, please explain why? *

Please explain your experience

Does your current church support your starting this campus? *

Yes
No

Do you have a home church and if “yes” where do you attend and for how long have you attended? *

Please list a pastoral reference: *

Please explain your experience

Do you attend church regularly? *

Yes
No

How long have you been attending there?

In what capacity are you currently serving in your local church?

If you are not currently serving in your local church, please explain why.

Please give a brief explanation of any ministry experience or volunteer work you have.

The Altar School And You

How did you hear about The Altar School? *

Briefly explain why you would like to start a Satellite Campus. *

What do you hope to accomplish through this Satellite Campus.? *

While attending, are you in agreement that you will attend a local church on a consistent basis while attending the school? *

Photo upload

Click or drag a file to this area to upload.

Please upload a personal portrait.

Application Fee

Price: $50.00

Stripe Credit Card *

Card

Name on Card

Total

$0.00

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Spiritual History

The Altar School And You