Institute for Discipleship Inquiry Form

Discipleship Application
Contact Information
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail*
Cell Phone*

Area CodePhone Number
E-mail*
Parent/guardian E-mail*
High School Attended:*
GPA:*
YesNo
Denomination:*
References

Please give name and contact information of four references.
Reference 1
Teacher*
Phone Number*

Area CodePhone Number
E-mail*
Reference 2
Pastor*
Phone Number*

Area CodePhone Number
E-mail*
Reference 3
Parent*
Phone Number*

Area CodePhone Number
E-mail*
Reference 4
Friend*
Phone Number*

Area CodePhone Number
E-mail*
Essay

All applicants need to answer each of the following essay questions in 100-300 typed words:
- What have you learned about God and about yourself during the last 4 years?
- Who has been the best role model for you in your Christian faith and what is the most important lesson that they taught you?
- If you could do any job and not worry about a paycheck, what would it be and why?
Type up your essay in a word processor and upload it here with your application.
Upload Essay Here

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Tell Us About You
What are your favorite subjects?*
What extracurricular activities were you involved in during high school?*
What has been your ministry or service involvement?*
What have been the highlights of your spiritual journey so far?*
Why would you like to participate in this program?*
Additional comments
Green TeamLeadership Southwestern
Discipleship

Southwestern College 100 College Street | Winfield, KS 67156-2499 | 1-800-846-1543
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Discipleship Application

Contact Information

References

Reference 1

Reference 2

Reference 3

Reference 4

Tell Us About You

Discipleship