Lead Texas Application
Please fill out the following information
All applicants must submit these items prior to July 15 priority deadline:
Personal Information
Name
*
First Name
Last Name
Current Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Currently living with
*
Parents
Roommate
Alone
Other
Permanent Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
Gender
*
Male
Female
Birthdate
*
-
Month
-
Day
Year
Date
Age
*
Email
*
example@example.com
Marital Status
*
Single
Married
Divorced
Widowed
Ethnic Background (optional)
Caucasian
Hispanic
African American
Asian American
American Indian
Other
Family Background
Name of Parent/Legal Guardian
*
First Name
Last Name
Parent/Guardian Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
Occupation/Employer
*
Name of Parent/Legal Guardian
First Name
Last Name
Parent/Guardian Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
Parents' Marital Status
*
Married
Separated
Divorced
Deceased
List Siblings and Their Ages
*
Health Information
Current Health
*
Excellent
Good
Fair
Poor
Do you have allergies or current dietary requirements?
*
Do you currently or have you ever taken mood altering medications (anti-depressants, Ritalin, etc.)?
*
Yes
No
If yes, please explain
List any other medications you are currently using.
*
Have you ever undergone psychological or mental treatment, including professional counseling?
*
Yes
No
If yes, please explain
List any physical limitations
*
Have you ever used illegal drugs?
*
Yes
No
If yes, please list drugs used and date of last use.
Do you currently smoke?
*
Yes
No
Do you currently drink alcoholic beverages?
*
Yes
No
If yes, list dates last used for alcohol and/or tobacco.
Do you currently have a Health Savings Plan or another form of medical insurance?
*
Yes
No
Personal Financial / Employment Background
Have you received a copy of the program fees for the year you are applying for and do you understand the cost for attending the Lead Texas program?
*
Yes
No
How do you plan to pay for your program fees?
*
Donation Letters/Personal Support
Financial Aid
Personal Savings
Other
Will you have the required, non-refundable deposit ($500) by the priority deadline (7/15)?
*
Yes
No
If no, please explain
Do you plan to apply for Federal Financial Aid (FAFSA is not applicable to Lead Texas' tuition)? To apply visit, www.fafsa.ed.gov
*
Yes
No
If no, please explain
Are you currently employed?
*
Yes
No
Current Employer
*
Position
*
Hours Per Week
*
Do you understand that Lead Texas students will not have time to hold continuous employment during their first and second years of enrollment, including part-time jobs?
*
Yes
No
Are you personally encumbered with debts?
*
Yes
No
Are you planning to bring an automobile?
*
Yes
No
If yes, do you have insurance on your vehicle?
Yes
No
Educational Background
Check last year completed
*
High School 11th
High School 12th
College 1
2
3
4
5+
Name of High School
*
City & State
*
Graduation Year
*
GPA
*
Check One
*
Diploma
GED
Please list college(s) attended
*
Do you understand that the tuition cost for transferable college credit / degree program through Lee University is in addition to Lead Texas program fees?
*
Yes
No
Church Background
Home Church Denomination
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
Website
*
Senior Pastor
*
Youth Pastor
*
How long have you attended this church?
*
Are you a member?
*
Yes
No
When did you accept Christ?
*
-
Month
-
Day
Year
Date
Where?
*
Have you ever been baptized in water?
*
Yes
No
Describe your current relationship with God.
*
Describe your devotional life and practices.
*
How supportive are your parents/guardians about your desire to attend Lead Texas?
*
Totally Unsupportive
Somewhat Unsupportive
Somewhat Supportive
Supportive
Very Supportive
Do you understand that if you attend Lead Texas you are making a 9 month commitment?
*
Yes
No
What makes you interested in coming to Lead Texas?
*
Describe any ministry and activities of the church in which you have served or are serving in leadership.
*
Describe any activities or opportunities outside the church in which you have served or are currently in leadership.
*
Please check the answer that is most applicable to your sense of "calling" at this time.
*
I am confident that God is calling me into a full-time ministry of some kind
I do not believe God is calling me into full-time ministry at this time
I am not sure, but am open to the idea that God is calling me into full-time ministry
Please mark all applicable options you are considering upon completion of Lead Texas
*
Seeking full-time employment
Pursuing a college degree (on campus)
Seeking placement for a vocational ministry
Other
List some of your gifts and abilities that you would like to use for Christ and develop through Lead Texas.
*
Have you ever been arrested?
*
Yes
No
Have you ever been convicted of a crime other than a traffic violation?
*
Yes
No
If accepted, I understand and am willing to make the 9 month commitment to Lead Texas and the Code of Conduct and Standards of the program. (A copy of the Code of Conduct and Standards will be reviewed with all the students during student orientation.)
*
Yes
No
Personal References
*
Name
Address
Phone
Email
Teacher
Relative
Non-Relative
Personal Recommendation
Each application for admission to Lead Texas must submit recommendations. This form should be filled out by a high school or college teacher, employer, or mentor. Family members are not acceptable for this recommendation. Serious consideration will be given to the comments provided; therefore, we ask that you complete the entire form carefully. *This form can be found & filled out through a link on the Lead Texas Website.
Pastoral Recommendation
This reference should be completed by your pastor, youth pastor, or other pastor. If a parent is your pastor please refer this form to the assistant/associate pastor or youth pastor in your church. If a person other than your pastor completes the form, please provide an explanation. *This form can be found and filled out through a link on the Lead Texas website.
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