Mountain Mover Ministries 30 Day Challenge Application

  • Mountain Mover Ministries 30 Day Challenge Application

    Apply to join the 30 Day Challenge program. Please complete all sections honestly and thoroughly.

  • Applicant Information

    Please provide your basic personal details.
  • Today's Date*
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  • Format: (000) 000-0000.
  • Date Available for Program*
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  • Date of Birth*
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  • Format: (000) 000-0000.

  • Family Background

    Tell us about your family.
  • Are you a Citizen of the USA?*

  • Education

    Your educational background.
  • Do you have a GED?*

  • Medical History

    Your health and medical background.
  • Have you been under a doctor's care for any reason in the last year?*
  • Do you have any medical conditions that require medication?*
  • Do you have any type of disability that would limit you while at MMM?*
  • Do you have any type of communicable illness or disease?*

  • Religious Background

    Your faith and spiritual history.
  • Are you willing to attend church, pray, and read the Bible regularly while in the (6) Month Challenge?*

  • Personal Habits

    Please answer honestly about your habits.
  • Have you ever used alcohol to get drunk?*
  • Have you ever used tobacco products or E-cigarettes?*
  • Have you ever smoked marijuana?*
  • Have you ever used other types of drugs to get high?*
  • Have you ever been involved with homosexuality?*
  • Have you ever been involved in witchcraft or the occult?*

  • Legal Record

    Tell us about your legal background.
  • Have you ever been arrested?*
  • Are you currently on probation or parole?*

  • Premature Departure Policy Agreement

    Please read and acknowledge the following policy.

  • Due to the fact that some students may not complete the 30 Day Challenge of the Mountain Mover Ministries program due to dismissal or a personal decision to quit, this is the MMM Policy regarding premature departure.  This page must be read, signed & dated prior to admittance.

    The following will occur at the point of premature departure:

    1- Anything left behind, for any reason, will become the property of MMM.

    2- Student forfeits any positive references from MMM.  This would include any community service hours generated.

    3- If a student wishes to return to MMM there will be a 30 day period of separation prior to student re-applying.  If a student is accepted back into program he starts over from the beginning.

    4- Departing student is not to contact anyone in the MMM environment for 90 days.  This would include Business and Church contacts made while in the program.

    I have read the above premature departure information and if I for any reason leave the MMM 30 Day Challenge I agree to submit to these policies.

  • Date Signed*
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  • 30 Day Challenge Program Agreement

    Please read and agree to the following statement.

  • I,     agree to abide by the policies of Mountain Mover Ministries (MMM) and state that I wish to enroll in the 30 Day Challenge and realize to graduate I must remain in the program until my designated completion date.

    I realize there is a $1000.00 non-refundable tuition fee due upon entry in the form of cash or a cashier’s check.

    I understand that (MMM) cannot be held responsible for personal property or injury to anyone who is in our program. Any personal property or money left at (MMM) after my departure becomes the property of Mountain Mover Ministries, Inc. It is further understood that if I do not cooperate with the rules and regulations of (MMM) I can be asked to leave.

    I also understand that (MMM) will allow students into the 30 Day Challenge program with “body fluid only” transmittable diseases. I will be unaware of these students and so I will practice safe hygiene and avoid contact with the body fluids of other students.

    I will fully cooperate with the rules of the program on these matters.

  • Date Signed*
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  • Should be Empty: