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GroundZero Application
Personal Information
Name
Email
Age
Phone
Address
Education
Highest Level of Education
High School Graduate
GED: General Educational Development
Associates Degree
Bachelors Degree
None
Current GPA
ACT Score
SAT Score
On a scale of 1-10, rate the level of effort you have put into your high school / college academics:
(1 = little to no effort, 10 - very high effort)
Explain
Church Background
Home Church
Denomination
Senior Pastor
Youth Pastor
Phone
How long have you attended your church?
How often do you attend church?
When did you accept Christ?
Have you been baptized in water?
Yes
Yes, as an infant
No
Whats your experience with the following ministries/groups - Select all that apply:
Street Ministry / Evangelism
Youth Ministry
Children’s Ministry
Senior Citizen Ministry
Missions
Worship/Music
Photography/Videography
Sound/Media/Lighting
Drama
Costume/Make-up
Publications/Journalism
Leadership
Poetry/Creative Writing
Rap
Other
Pleases share testimony
Family Background
Biological Father
Name
Email
Phone
Occupation
Address
Has your father accepted Christ?
Yes
No
Marital Status
Married
Separated
No
Biological Mother
Name
Email
Phone
Occupation
Address
Has your father accepted Christ?
Yes
No
Marital Status
Married
Separated
No
Other Family
Number of Brothers
Number of Sisters
If parents were separated or divorced, how old were you at the time?
If your father and/or mother is deceased, how old were you at the time?
If your parents remarried, describe your relationship with you step-parent(s)/step-siblings(s)
Check all of the statements that describe your family upbringing:
Excellent Christian Home
Parental Job Instability
Warm Relationship with Parents
Warm Relationship With Siblings
Relatives Lived Nearby
Close With Extended Family
Sibling Rivalry
Physical Abuse As A Child
Father/Mother Absent
Mental Emotional Abuse
Parental / Guardian Contact
I hereby give permission to GroundZero School of Discipleship to disclose information to my parents/guardians and family about the GroundZero Program.
References
Ministry Reference
Name
Email
Phone
Occupation
Relation
Address
Personal Reference
Name
Email
Phone
Occupation
Relation
Address
Personal Reference
Name
Email
Phone
Occupation
Relation
Address
Personal Reference
Name
Email
Phone
Occupation
Relation
Address
Personal Evaluation
What are three of your Strengths?
What are three of your weaknesses?
What area of ministry would you describe as your gifting?
What qualities are you hoping to acquire as you grow in spiritual leadership?
What are your future plans after GroundZero?
Please list any physical limitations:
Have you been diagnosed with any physical or mental illnesses? If so, please explain:
Have you ever been hospitalized for your physical or mental illnesses? If so, please explain:
What medications (for physical and/or mental illnesses) are you currently taking:
Have you ever:
I have used Illegal Drugs
Used Tobacco Products
Drank Alcoholic Beverages
Please provided the date of last use:
Commitment
It is my desire to pursue God, have a teachable spirit. And faithfully uphold the commitments covenants of GroundZero School of Discipleship?
Responsibility + Accountability = Maturity. I am committing to being a person of integrity, responsibility, and accountability throughout the duration of your time here at GroundZero?
I am in a current dating relationship.
Yes
Separated
No
I am willing to not date during my first year while at GroundZero.
I am willing to share a room while at GroundZero?
Thank you!
Your submission has been received!
We will reach out to you soon.
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