Defined Application

Defined Application
Defined is a ministry of Ironwood.

You will want to set aside about 45 minutes to complete this application and three personal essays at the end.

Submitting this application is not a final committment on your part to be a part of Defined, nor is it a guarantee of acceptance into the program. It simply lets us know that you are seriously considering Defined as an option.

Want to fill out and send a paper copy instead? Download the PDF here.
Personal Information
Name*

First NameLast Name
Birthday*

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Height*
Weight*
MaleFemale
YesNo
If so, please describe:*
Upload a recent photo of yourself here:*

Cancelof

Family Information
Father's Name (or legal guardian)*

First NameLast Name
Mother's Name (or legal guardian)*

First NameLast Name
Parents' Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parents' Address #2 (if different)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Father's Phone*
Please enter a valid phone number.
Father's Email*
example@example.com
Mother's Phone*
Please enter a valid phone number.
Mother's Email*
example@example.com

Education Information
From what high school did you graduate?*
What year did you graduate?*
YesNo
If so, please explain.*
YesNo
If so, when and where?*

Church Information
Name of your home church:*
How long have you been attending?*
Pastor's name:*
Church Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Church Phone Number*
Please enter a valid phone number.
Church Email
example@example.com

Specific Personal Information
What kind of involvement do you have at your church?*
Do you regularly have devotions?*
At this point in your life, what do you think God wants you to do?*
How are you serving the Lord right now?*
What do your parents think about your interest in coming to Defined?*

Specific Personal Information
Are you currently using any types of tobacco, drugs, alcohol, or vapes?*
YesNo
If so, please explain the circumstances:*
Yes
Confirm

Personal Essays
In no less than 200 words, tell us how and when you were saved and how salvation has affected your daily life.*
In no less than 200 words, tells us what are your goals and expectations for your coming to Defined. Please be as specific as possible.*
Please tell us why you want to be a part of Defined.*

References
Please give the names and contact information of the references requested below. When you submit this form, your references will be emailed a link to fill out a reference for you.

Our final decision on your application will wait untill all references have submitted a form to us.
Current Pastor*

First NameLast Name
Pastor's Phone Number*
Please enter a valid phone number.
Pastor's Email*
example@example.com
Current Pastor's Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Current (or most recent) Youth Pastor/Youth Leader*

First NameLast Name
Youth Leader's Phone Number*
Please enter a valid phone number.
Youth Leader's Email*
example@example.com
Youth Pastor's Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Current (or most recent) Employer or Work Supervisor*

First NameLast Name
Employer's Phone Number*
Please enter a valid phone number.
Employer's Email*
example@example.com
Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Should be Empty: