`1 s Dear Atlanta SOM Applicant, We are excited that you have taken the time to apply to the Atlanta School of Ministry. If you have any questions, please refer to the information packet, www.atlsom.com, or call our office at (404) 697-1544. Our school offers two different sessions January-August (1/10/2015-8/8/2015) and September-June (9/12/2015-6/5/2016). On the last page of the application, please remember to circle which session you are applying for. Once you have completed the application, place it in an envelope along with a typed or neatly written testimony (500-words or less), a photo, and the $100 application fee (Note: the fee is non-refundable). Everything may be mailed to the ATL SOM offices: (address below) Atlanta School of Ministry PO Box 54532 Atlanta, GA 30308 After we have received your application, an individual from the School of Ministry staff will contact you and set up a phone interview. After this is completed the staff will pray over your application, asking for God’s leading and His will for your life in this season. Thank you for considering the Atlanta School of Ministry, Atlanta School of Ministry Staff PO Box 54532 Atlanta, GA 30308 www.atlsom.com (678) 653-3171 Atlanta School of Ministry Application PERSONAL INFORMATION Full Name Present Address City State Phone Number Zip Code Email Birth Date_ Age Facebook Address: www.facebook.com/_________________________________ Marital Status (circle one) Single Married Divorced if married or divorced, how long? Note: Please submit a second application for spouse if both are applying FAMILY BACKGROUND Name of Father/Guardian Address City State Zip Code State Zip Code Phone Number_______________________ Accepted Christ? Yes No Occupation Name of Mother or Guardian Address City Phone Number_______________________ Accepted Christ? Occupation Yes No 3 MEDICAL BACKGROUND How would you describe your health? [ ]Excellent [ ]Good [ ]Fair [ ]Poor List any allergies List any physical limitations List any current medications Have you ever used Illegal drugs? Yes No Dated last used Have you ever used tobacco? Yes No Date last used Have you ever consumed alcohol? Yes No Date last used EMPLOYMENT HISTORY Present Employer Position_ Date Hired Past Employer Position_ Quit Laid Off Date Hired Fired Other Tuition Payment Plan How do you plan to pay for your tuition? Will you have the total tuition by Orientation? Yes No If no, please explain Do you have your own vehicle? Do you have health insurance? Yes Yes No No List any debts, loans, and payments that you have, including the amount due: 4 Will your debts be paid off by the start of the SOM session? Yes No If no, how will you make the payments? CHURCH BACKGROUND Name of Home Church Denomination Address City State Zip Code Senior Pastor Youth Pastor How long have you attended this church? List the different ministries you are involved in: Are you a member of this church? Yes No When did you accept Christ? Have you been baptized with water? Have you had an Acts 2:4 experience? Where? Yes No Yes No How many times a week do you attend church? How do your parents/guardians feel about you attending SOM? References: (Must include a pastor as a reference) [Name. Relation. Phone Number] 5 CHURCH BACKGROUND CONTINUED What is your definition of church? GENERAL QUESTIONS What do you plan to do after SOM? How did you hear about SOM? If accepted, are you willing to make a nine-month commitment? Yes If accepted, are you willing to make a commitment to pay the total tuition? What size t-shirt do you wear? [ ]S [ ]M [ ]Lg [ ]XL [ ]XXL [ ]3XL No Yes No 6 TUITION AND FEES FOR BOTH SEMESTERS Room and Board, Tuition, Books, and Stateside traveling - $6,400 (1st year) Which session are you applying for? January September ADDITIONAL OPTIONS FOR THOSE INTERESTED: Would you like to sign up for the Worship Program? Yes No The Purpose of the Worship Program is to equip musicians and singers with the tools necessary to effectively lead people into victory and intimacy with the Lord. It is for anyone who wants to go deeper in their walk with the Lord and those who are called to the worship ministry. In this course you will be able to participate in: -Prophetic Worship -Leadership and Team Development -Music Lessons -Music Theory -Recording -Classes on Intercession & Spiritual Warfare *There is an additional cost of $660 for the Worship program to cover the extra classes and lessons. Would you like to pursue Accredited College Options? Yes No Although the Atlanta School of Ministry is not an accredited institution, because of the level of depth in our curriculum program, multiple schools to give our students degree options have approached us. Based on reviewing our syllabus, core faculty/staff and interacting with alumni, we currently have options which will allow the transfer of credits for all classes passed with a grade of “C” or above towards an Associates or Bachelors. In most cases, those who complete 3yrs with us may only have to complete one year of general education courses weather enrolling student as an online or traditional student. For more information email us at [email protected]. *In order for students to be enrolled in college options they need to posses their own laptop. Would you like to sign up for Georgia School of Ministry? Yes No GSOM provides the opportunity for a student to complete requirements for Ordination and Licensing credentials with the Assemblies of God. Students who sign up attend a weekend course once a month on an outside campus. There are different levels of licensing available for interested students, for more information email us at [email protected]. *For more information visit http://gadistag.org/471425.ihtml I HAVE HONESTLY COMPLETED THIS APPLICATION FORM AND HAVE ANSWERED THE QUESTIONS TO THE BEST OF MY ABILITY AND if accepted, I agree to take full responsibility of paying the total tuition. I understand that I am responsible for the vehicle, if I choose to bring one, including maintenance, insurance, etc. I agree to provide a current DMV record, proof of insurance, and a copy of my driver’s license. I agree to cover all expenses and damages if I am borrowing a vehicle and have an accident or receive a citation. Print Name: Date: Signature: ______________________________________________________ DON’T FORGET TO INCLUDE 1. Personal Testimony 2. Photo 3. $100 Application fee