LA Application Form

EDUCATIONAL INFORMATION
Name of High School *
School Phone Number *
Please enter a valid phone number.
School Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Date of Graduation *

Month Day Year
Date
Did/Will you graduate early? *

Yes No
From which type of high school did/will you graduate? *

Public Private Home School
Date you took/will take the GED (if applicable):

Month Day Year
Date
GED Total Score
Date you took/will take the ACT (if applicable):

Month Day Year
Date
ACT Total Score
Date you took the SAT:

Month Day Year
Date
ACT Total Score
Have you ever been dismissed, place on probation or required to leave school for any reason? *

Yes No

ACTIVITIES AND AWARDS
Please list any church/community involvement, extracurricular activities, special awards or recognitions:

CODE OF HONOR PLEDGE
Please read the following statement thoughtfully before signing. If accepted to Applied Life Leaders Academy, your continued enrollment will depend on your working within these guidelines. Applied Life Leaders Academy is dedicated to providing a quality internship within the Christian framework. Our vision is to motivate the next generation to passionately pursue Jesus Christ and to equip them with the life skills necessary to reach their full potential in Christ. Leaders Academy is designed to teach this culture how to take God’s Word and apply it to their everyday lives so that they can achieve the victories that God has for them. Applied Life Leaders Academy takes seriously its part in developing your leadership and is committed to providing the following:

An opportunity to grow
A stimulating spiritual environment
Assistance in finding God’s direction for your life
An interdependence and commitment to the body of Christ which is the church

The Leaders Academy is not responsible for illness, theft, accidents on or off campus or any other mishap of personal detrimental nature. It is expected that you will take your responsibility as an intern seriously. We treasure students who strive for and maintain high moral and ethical standards and who can contribute to this high quality of life on our campus. As part of our commitment to provide a distinctive lifestyle experience, the Leaders Academy prohibits on and off campus possession or use of alcoholic beverages, illegal drugs, tobacco, gambling, sexual misconduct, cheating, theft, and conduct inconsistent with the goals of this ministry. An important element of “community” at the Leaders Academy is corporate worship and fellowship. Therefore, church attendance is required. If admitted to Applied Life Leaders Academy, I will

1) Earnestly seek to grow in body, soul, and spirit

2) Strive to uphold in both spirit and letter the standards of the Leaders Academy

3) Work to make a positive contribution to the Leaders Academy community

Applied Life Leaders Academy reserves the right to dismiss any student who chooses not to live up to the standards set forth by the Leaders Academy. (All tuition and fees paid are non-refundable).
Intern Signature *

Clear
Date *

Month Day Year
Date
Parent Signature *

Clear
Date *

Month Day Year
Date

UPLOADS
Biographical Essay

Answer the following questions in a double-spaced typed essay in two pages or less.

1. Please explain your personal relationship with Jesus Christ. What does it mean to you to be a follower of Christ?
2. Please tell us about the persons, places and events that have influenced your life.
3. What contribution do you feel you can make to the Applied Life Leaders Academy community?
Biographical Essay File Upload *

Cancel of
High School Transcript or GED *

If you don't have this yet, just upload a word doc or pdf stating you don't have it yet and when you expect to receive it. Once you receive it, please email to admissions@appliedlife.com.
Cancel of
Official ACT and/or SAT Scores

If you don't have this yet, just upload a word doc or pdf stating you don't have it yet and when you expect to receive it. Once you receive it, please email to admissions@appliedlife.com.
Cancel of
Official Immunization Records *

If you don't have this yet, just upload a word doc or pdf stating you don't have it yet and when you expect to receive it. Once you receive it, please email to admissions@appliedlife.com.
Cancel of

PERSONAL INFORMATION
Why do you desire to attend Applied Life Leaders Academy? *
How did you first hear about Applied Life Leaders Academy? *
List other internships to which you have applied:
Have you ever been convicted, plead guilty or no contest to a felony charge? *

Yes No
Please explain why you were convicted, pled guilty or no contest to a felony charge?
I declare that all information given is true to the best of my knowledge. I have read and, if accepted to Applied Life Leaders Academy, agree to abide by the Code of Honor Pledge
Intern Signature *

Clear
Date *

Month Day Year
Date
Please verify that you are human *
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LEADERS ACADEMY APPLICATION

EDUCATIONAL INFORMATION

ACTIVITIES AND AWARDS

MEDICAL HISTORY

FAMILY HISTORY

CODE OF HONOR PLEDGE

UPLOADS

PERSONAL INFORMATION