Living Water School Of Ministry

Applicant Personal Information
Name*
First Middle Last
Date of Birth*
MM
DD
YYYY
Social Security #
Address
Include Apt # if any Address Line 2 City State / Province / Region ZIP / Postal Code
Home Telephone
Work Telephone
Email
Gender
- Male
- Female
Citizenship Status
- US Citizen
- Permanent Resident
- Not a US Citizen or Permanent Resident
Country Where You Are From
Country
Ethnicity
Prior Address if less than three (3) years at present address
Include Apt # if any Address Line 2 City State / Province / Region ZIP / Postal Code
In case of Emergency Contact
Telephone
Are you interested in taking classes:*
- On-site
- Online

Education
Highest Level Of Education
School Name
School Location
Military
Do you have affiliation with any United States Armed Forces?
- Yes
- No
If YES, please select branch you are affiliated with
Military Status
- Currently Serving
- Veteran
- Dependent
- Spouse
If "Currently Serving" please select status
- Active Duty
- Reserve
- National Guard

Employment
Employer
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Occupation
Length of Employment
Purpose for Enrollment
What is your purpose for enrolling in Living Water School of Ministry?

Church
Name of Church where you a member
Telephone
Pastor
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
When did you receive Jesus Christ as your personal Lord and Savior?
Have you received the Baptism of the Holy Spirit?
- Yes
- No
List the names of other churchs you have attended regularly within the past five years
List ALL church work (youth/children, administrative, programs, activities, ministries, usher, choir, etc)
Have you ever been asked to leave a church for any reason?
- Yes
- No
If YES, please explain
List any gifts, callings, training, etc...
List any Diploma/Certificate/Degree earned
Diploma/Certificate/Degree Year Earned

Certification & Payment
Certification*
I agree to the below certification
I certify that the information contained in this application is correct to the best of my knowledge. I consent to and authorize any church listed in this application to give you any information regarding my character.
If this application leads to acceptance, I understand that false or misleading information in my application or interview
may result in my release.
Statement of Agreement*
I agree to the below statement of agreement
Living Water School of Ministry will under no circumstances, allow immoral living which God has plainly stated that He abhors. Living Water School of Ministry will not condone or allow conduct related to homosexual activities, fornication, adultery, social dancing, occult activities, tobacco, intoxicants, (including wine, beer and habit forming or illegal drugs).

Any student found actively involved in any of the above activities will be subject to immediate dismissal from school with no refund of tuition.

I agree to be bound by the policies of Living Water School of Ministry and to refrain from any immoral living which God has plainly stated that He abhors.
Please Upload Your Driver's License or State Issued ID for Verification Purposes*
$25 Non-Refundable Application Fee*
Price: $25.00

Living Water
School of Ministry

Diploma/Certificate/Degree	Year Earned