Training Center Application

Name: *
Address:
City:
State:
Zip code:
Country:
Sex:

Male Female
Phone: *
E-mail: *
Age *
How did you hear about the OGTC?
Date of High School Graduation
Indicate when you wish to enroll

May - Aug Trimester Sept - Dec Trimester Jan - April Trimester
I expect to enroll as a:

Freshman Transfer Student Graduate Student
Church Information
Church Name:
Phone Number

Area Code Phone Number
Fax Number

Area Code Phone Number
Pastor's Name:
E-mail
Youth Director:
Church Address:
City:
State:
How did you hear about the Our Generation Training Center?
What direction has the Lord already given you about your future ministry?
Application for Admission
High School attending or Graduated from:

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Are you being or have you been home schooled?

Yes No
Have you taken the ACT?

Yes No
Have you taken the SAT I?

Yes No
Please List all postsecondary schools you have attended.
Have you ever been denied enrollment, suspended or dismissed from any school?

Yes No
Do you have any outstanding college debts?

Yes No
Student Health Profile/Personal Information
Emergency Contact

First Name Last Name
Phone Number

Area Code Phone Number

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Insurance Information
Insurance Provider
Group/Policy
Policy holder
General Information

Prescription medications taken regularly require a written physician’s explanation of the reason for taking.
</p>
Previous Physicians
Physician 1

First Name Last Name
Specialty

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Physician 2

First Name Last Name
Specialty

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Do you have a physical limitation or a known learning disability? If so, please explain.
Are you allergic to any medication, food, or substance? If yes, please specify which allergy.
Will you need allergy injections during the semester?

Yes No
List of medications used on a regular basis, doses, and reasons for taking.
Will you need injections while attending the Our Generation Training Center? If so, specify the type of injection.
Previous and Present Medical Problems
Hospitalizations - Please include diagnosis and dates.
Surgeries - Please include type of operation(s) and dates.
Injuries - Please include type, complications, any permanent disabilities and dates.
Have you ever used any illegal, injectable, or recreational drugs? If so, list the type of drug, approximate length of usage, and when last used.
Have you ever used alcohol on a regular basis? If so, please list approximate length of usage and when last used.
Check any condition you presently or previously have suffered

Allergy Heart Valve Problem Anemia (Including sickle cell anemia) Hepatitis Asthma Herpes Bleeding Disorder High Blood Pressure Blindness (Complete or Partial) Hypoglycemia Cancer (Including Leukemia, Hodgkin's Disease) Infectious mononucleosis (past 6 months) Cystic Fibrosis Kidney infection or stone Diabetes Malaria Diet Control Migraine headaches Insulin Parasitic disease Oral Medication Pneumonia Dysentery Polyps of the colon Epilepsy or other seizure disorder Rheumatic fever Glaucoma Rheumatoid arthritis Hearing loss (complete or partial) Stomach ulcers Heart Disease Thyroid trouble Heart Murmur Tuberculosis
Has your job or schooling ever been interrupted because of emotional problems?

Yes No
Have you ever been diagnosed with an eating disorder such as anorexia or bulimia?

Yes No
Have you ever been hospitalized or treated for anxiety, depression, or psychosis?

Yes No
Explain any "Yes" answers.
Personal Testimony
Testimony of Salvation:
Testimony of your call to missions (if applicable):
Testimony of your call to preach (if applicable):
Testimony of your call to the ministry (if applicable):
Testimony of God giving you direction to a certain field or area of ministry (if applicable):
References
Pastor

First Name Last Name

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number

Area Code Phone Number
E-mail
Employer

First Name Last Name

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number

Area Code Phone Number
E-mail
Personal (non-family members)

First Name Last Name

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number

Area Code Phone Number
E-mail
Personal (non-family members)

First Name Last Name

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number

Area Code Phone Number
E-mail
To be Read by the Student

By submitting this form I am authorizing the release of the following information to be considered in my application for admission to the Our Generation Training Center, and I understand that all information will be held in confidence by the college and will not be released to me or anyone else. I understand that the recommendations will be mailed directly to the Our Generation Training Center by my pastor.
Should be Empty:

Church Information

Application for Admission

Student Health Profile/Personal Information

Personal Testimony

References