FULL TIME PROGRAM APPLICATION

In partnership with

244 Williams Drive, Kill Devil Hills, North Carolina 27948

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Introduction Students should fill out the application as honest as possible without fear that their answers will prohibit them from being accepted into the Liberty School of Ministry. All information is held under strict confidence. Please fill out the application completely, if something does not apply to you simply put “N/A”.

Application Process 1. Application fee of $25.00 is due with application. Make checks payable to

“Liberty Christian Fellowship,” and in the memo line write “LSM with the students name” to ensure their payment is applied to their account.

2. In person interview once the application has been processed. Application will not be processed until application fee payment, and all required information is submitted.

3. A deposit of $250.00 is due 30 days after acceptance in order to assure us that you are attending, and allows us to prepare for your arrival. This deposit will be applied to the student’s tuition.

4. Half of the tuition is due one week before Fall Semester. 5. Second half of tuition is due one week before Spring Semester. 6. Total amount of tuition will equal $3,500.00.

Personal Information • Name: ___________________________________________________________

First Middle Last

Address: ____________________________ City: _____________ ZIP: _______

• Phone Number: ____-____-__________ � home � cell � other

• Email Address: ____________________________________________________

• Gender � male � female Date of Birth: ____-____-______ Age: _____

• Marital Status: � single � engaged � widow/widower

� married (Anniversary: ___/___/______)

� separated � divorced

• Do you have children? Yes No How Many? ___

• Driver’s License type photo attached here:

Attach Photo Here

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Personal Evaluation

• What are you passionate about?

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• What do you do for fun?

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• What do you consider to be your talents, gifts, and strengths?

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• What would you consider to be your weaknesses and struggles?

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• Why do you want to attend Liberty School of Ministry?

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Family

• Name of spouse, if married? ____________________________________

• Father’s name? ________________________________________________

o Phone: ____-____-________

• Briefly describe your relationship with your dad. ___________________

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• Mother’s name? ______________________________________________

o Phone: ____-____-________

• Briefly describe your relationship with your mom. ___________________

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Education

• Did you graduate High School or earn a GED? � yes � no

o Year graduated or GED? _________

• Did you attend College, or Trade School?

o Graduate? � yes � no Month/Year Graduated? _________

o What was your Major? ___________________________________

o Credits earned? ___________

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Employment Current Employer: _______________________________________________________

Name of Supervisor: ______________________________ Phone: (___) ____-______

Mailing Address: ______________________________ City: _________ ZIP: ________

Your Position: _____________________________ Length of Employment: ________

Briefly describe your responsibilities: ________________________________________

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Please continue with the past two years of your employment history:

Employer: ________________________________________________________

Name of Supervisor: ___________________________ Phone: (__) ___-_____

Mailing Address: _________________________ City: _________ ZIP: ________

Your Position: ________________________ Length of Employment: ________

Briefly describe your responsibilities: ___________________________________

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Reason for leaving: _________________________________________________

Employer: ________________________________________________________

Name of Supervisor: ___________________________ Phone: (__) ___-_____

Mailing Address: _________________________ City: _________ ZIP: ________

Your Position: ________________________ Length of Employment: ________

Briefly describe your responsibilities: ___________________________________

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Reason for leaving: _________________________________________________

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Spiritual Information

• When did you accept Jesus Christ as your personal Savior? ________________

• Have you been baptized? � yes � no

• Please give a brief statement of your Christian experience of how you came to know Jesus Christ as your Savior, and your current walk with God in 300 words or less.

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• Do you attend a local church in your area? � yes � no

o How long have you attended church there? _______________________

o Church name: _______________________________________________

Mailing Address: ______________________________________________

Pastor’s name: _______________________________________________

Church phone number: ________________________________________

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o Are you a member? � yes � no

Why or why not? ____________________________________________

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History • Have you used tobacco in the last year? � yes � no

If yes, please explain. ______________________________________________

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• Have you consumed alcoholic beverages in the last year? � yes � no

If yes, please explain. ______________________________________________

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• Have you used any illegal drug (including marijuana) in the last year? � yes � no

If yes, please explain. ______________________________________________

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• Have you abused prescription drugs (taken outside the recommended dosage) in the last year? � yes � no

If yes, please explain. ______________________________________________

• Have you viewed pornography in the last year? � yes � no

If yes, please explain. ______________________________________________

Also, how are you abstaining from pornography since you last viewed it?

Please explain. ____________________________________________________

• Have you had sex with anyone outside of marriage within the last two years? Liberty School of Ministry defines sex as intercourse, or oral sex. � yes � no

• Have you struggled with homosexual behavior, or same sex attraction within the

last two years? � yes � no

If yes, please explain. ______________________________________________

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• Also, how are you abstaining from this type of behavior? ___________________

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• Have you ever been arrested? � yes � no

If yes, please give a brief explanation. ________________________________

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Have you ever been convicted of a crime? � yes � no

If yes, when and where? ____________________________________________

Please give a brief explanation. ______________________________________

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• Have you ever been involved in the occult, witchcraft, Wicca, cults, or any other religion besides Christianity? � yes � no

If yes, please give a brief explanation. ________________________________

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Health • Please describe any physical, emotional, or mental conditions that you have

received treatment for in the past 5 years.

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• Name of any illness(es) you have. ________________________________

• Medication names and when these medications were last used?

Medication: ___________________________ Last Used: _____________

Medication: ___________________________ Last Used: _____________

Medication: ___________________________ Last Used: _____________

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• Are there any physical, emotional, or mental limitations you might experience while attending Liberty School of Ministry? � yes � no

If yes, please give a brief explanation. ___________________________

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Finances • How did you hear about Liberty School of Ministry?

� Internet � From a friend � I attend Liberty Christian Fellowship � I received promotional materials � I was encouraged to enroll by _____________________ � Other: ________________________________________

• How do you plan to pay for your educational and living expenses?

� Part-time Employment � Full-time Employment � Payment Installments � Pay in Full upon Registration � Other: _______________________

• Have you previously applied to Liberty School of Ministry? � yes � no

o Were you accepted or denied? _______________

o Date previously applied? ____________________

Letters of Recommendation • Please attach your letters of recommendation to this application. Letters should

include the following:

o Must have known you for one year. o Cannot be related to you by birth or marriage. o Cannot be someone you are dating.

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Pastoral Recommendation Form

• Pastor’s Name: ____________________________________________________

• Pastor’s Position on Staff: ____________________________________________

• Church Name: _____________________________________________________

Mailing Address: _____________________ City: _____________ ZIP _______

• Phone: (____) ____-________ Email: ________________________________

• How long have you known the applicant? _______________________________

• How well do you know the applicant? __________________________________

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• Please describe the applicant’s level of involvement at your church.

As a church member: _______________________________________________

As a staff member: _________________________________________________

• The school consists of a rigorous and demanding schedule. Do you foresee any struggles for the applicant that would hinder their growth? � yes � no

If yes, please explain: ______________________________________________

• Do you believe the applicant is capable of receiving correction, and has a teachable attitude? � yes � no

Please explain: ____________________________________________________

• What are the strengths and weaknesses of the applicant? __________________

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• If able, please describe the applicant’s family life: ________________________

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• Additional comments or explanations: __________________________________

Signature: __________________________________ Date: ____/____/________

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Personal Recommendation Form

• Name: _______________________________ Relationship: _______________

• Mailing Address: __________________________________________________

• Phone: (___) ___-________ Email: _________________________________

• How long have you known the applicant, and how well do you know them?

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• The school consists of a rigorous and demanding schedule. Do you foresee any struggles for the applicant that would hinder their growth? � yes � no

If yes, please explain: ______________________________________________

• Do you believe the applicant is capable of receiving correction, and has a teachable attitude? � yes � no

Please explain: ____________________________________________________

• What are the strengths and weaknesses of the applicant? __________________

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• If able, please describe the applicant’s family life: ________________________

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• Additional comments or explanations: __________________________________

Signature: __________________________________ Date: ____/____/_______

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IMPORTANT The application will not be processed until all requirements are submitted:

• Drivers License type photo attached

• Pastoral letter of recommendation

• Two recommendation letters from friends, co-workers, or employers (spouse or parental letter do not count).

• Non refundable application fee of $25.00

• Please make payment to

Liberty School of Ministry 244 Williams Drive Kill Devil Hills, NC 27948

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Standards and Expectations Spiritual    Passionate    Relational      Friendly      Watchful      Dedicated      Punctual      Healthy          Listening    Involved    Teachable      Integrity      Finances      Prayer  

Actively  growing  in  your  relationship  with  Christ.    Heart’s  desire  is  to  see  God’s  Kingdom  built.    Faithfully  working  on  positive  family,  church  and  community  relationships.    Mature  in  developing  peer  relationships  and  above  reproach  with  those  of  opposite  sex  (Ephesians  5:3).    Taking  diligent  care  to  avoid  guy-­‐with-­‐girl  situations  that  might  be  construed  as  inappropriate  or  compromising  (Proverbs  22:3).    Faithfully  carrying  out  God’s  call  on  life  in  all  areas  of  life  (Academics,  occupation,  money,  marriage,  etc.).    Be  on  time  to  LSM  functions  in  order  to  honor  the  time  of  those  involved.    Student’s  are  expected  to  honor  their  body,  and  abstain  from  any  illegal  activity  including,  but  not  limited  to,  drug  use,  underage  drinking,  and  sexual  activity  outside  of  marriage.  Students  are  also  expected  to  maintain  a  healthy  body  and  practice  good  hygiene.    Above  reproach  in  the  areas  of  music,  video,  media,  and  internet.    Actively  attending  the  Sunday  morning  services  and  LSM  events.    Student  must  maintain  a  humble  and  teachable  attitude  throughout  the  year  in  order  to  aid  in  the  growth  process.    Student  must  maintain  an  honest  attitude  toward  God,  the  LSM  leaders,  and  themselves.    Student  is  responsible  for  the  entirety  of  tuition  regardless  of  their  completion  of  the  program.    Student  will  continually  pray  for  the  LSM  staff,  LCF  staff,  and  their  fellow  students  and  church  congregates.  

___________________________________ Student signs in agreement