LifeCompass Application Form

Application for Gap Year

Please fill out the application form carefully. At any point you can save and complete the application later.

Personal Information
Full Name as it appears on your passport*

First NameMiddle NameLast NameSuffix
Name you prefer
Gender*

Personal Information
Birth Date*

MonthDayYear

Personal Information
E-mail*

Confirmation Email
Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Personal Information
Emergency Contact Name*

First NameLast Name
Relationship*
Emergency Contact Phone Number*

Area CodePhone Number
Emergency Contact Email*
example@example.com
Emergency Contact Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Personal Information
Any Physical Limitations?*

YesNo
If 'Yes' please explain
Any Allergies?*

YesNo
If 'Yes' please explain
Any Medications?*

YesNo
Please list any medication

Education Background
Highest Education Level Completed*
Areas of Focus
Clubs, Associations or Extracurriculars

References
Pastor Reference*

First NameLast Name
Pastor Reference Email*

Confirmation Emailexample@example.com

References
Teacher/Mentor Reference*

First NameLast Name
Teacher/Mentor Reference Email*

Confirmation Emailexample@example.com

References
Other Reference*

First NameLast Name
Other Reference Email*

Confirmation Emailexample@example.com

Your Story
Describe the circumstances surrounding you putting your faith in Christ. *
i.e. How you became a Christian.

Your Story
Describe what your current relationship with God looks like.*

Your Story
The areas of your character you are presently seeking to further develop and improve.*

Your Story
Share a little about your talents and strengths and in what dynamic ways has God used them.*

Your Story
Your long-term goals.*

Your Story
Your relationship with your local church, including areas of ministry, service and leadership experience.*

Your Story
Your business, professional, mission-related or other significant experiences.*

Your Story
Your relationship with your family.*
How does your family feel about you plans to enroll in LifeCompass Gap Year?*

Your Story
Why do you want to do a gap year and what is your interest in missions?*

Your Story
Briefly explain the gospel as if you were sharing it to a non-believer.*

Your Story
How did you first hear of LifeCompass?*
What reason most influenced your decision to apply?*
What expectations do you have for this course?*

Thank you!

There is a $50 non-refundable application fee prior to processing. We will email you an invoice for payment.
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