Lifework Leadership Participant Application

Lifework Leadership Participant Application
To be considered for participation in the 2013-2014 Lifework Leadership class, please complete this application. If you have questions, please contact Mike Cook, Program Assistant, at 419-207-6739 or at mcook1@ashland.edu.
Standard Tuition for Lifework Leadership is $2500.00. Upon approval of your application, a $500.00 deposit will be required to reserve your place in the class. The deposit will be credited to your tuition amount. Remainder of tuition will be due by August 30, 2013, unless an alternate payment arrangement is requested and approved.
Scholarships are available for qualifying applicants with legitimate need. For a scholarship application, please contact Mike Cook at 419-207-6739.
Personal Information:
Full Name

First NameLast Name
Birth Date

MonthDayYear
Phone Number

Area CodePhone Number
Cell Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail
Employment Information:
Current Employer:
Organization Type:
Employer Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Work Phone Number

Area CodePhone Number
Position:
E-mail
Education Information:
Name of Most Recent School:
City/State:
Major (if applicable):
Highest Level or Degree:
Spiritual Information:
Name of Church/ Spiritual Community:
Church Address (City / State):
Name of Pastor/Priest:
Roles / Ministries in which you currently participate:
Please provide two references:
First Reference:
Address (City / State):
Phone Number

Area CodePhone Number
Second Reference:
Address (City / State):
Phone:
Personal Journey and Expectations:
Please briefly describe your personal spiritual journey:
Please briefly describe your reason for applying for Lifework Leadership, and your expectations from the experience:
Should be Empty:

Lifework Leadership Participant Application

To be considered for participation in the 2013-2014 Lifework Leadership class, please complete this application. If you have questions, please contact Mike Cook, Program Assistant, at 419-207-6739 or at mcook1@ashland.edu.

Scholarships are available for qualifying applicants with legitimate need. For a scholarship application, please contact Mike Cook at 419-207-6739.

Personal Information:

Employment Information:

Education Information:

Spiritual Information:

Please provide two references:

Personal Journey and Expectations: