Raw Score for this Application: out of 33 - 0%

Q1. Have you completed Foundations in Christianity?



Q2. Have you completed Foundations in Priesthood?



Q3. Do you have a personal/ministry website? If so, please provide the web address. (Example: http://www.me.com)


Q4. Do you have a Twitter account? If so, please provide it below. (http://www.twitter.com/yourtwittername)


Q5. Do you have a Facebook account? If so, please provide it below. (http://www.facebook.com/username)


Q6. Do you have a LinkedIn account? If so, please provide it below. (http://www.linkedin.com/username)


Q7. Do you have access to a computer for the completion of the MIT coursework?



Q8. Highest level of education?

Q9. Name, Location, and Years attended. (High School) (From: MM/YYYY-To: MM/YYYY)
SCHOOL’S NAME SCHOOL’S CITY, STATE FROM: TO: FIELD OF STUDY: DEGREE/DIPLOMA:
1 - School of Hard Knocks
City: Macon}
State:
 Month: 3
Day: 10
Year: 1962
Month:3
Day: 9
Year: Engineering
 Engineering BA
2 - Happy School
City: Soona}
State:
 Month: 5
Day: 6
Year: 1970
Month:6
Day: 9
Year: Arts
 Arts BS
3 - Junior College
City: Dunk}
State:
 Month: 3
Day: 3
Year: 1954
Month:3
Day: 6
Year: Fine Arts
 Fine Arts MS
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Q10. Do you have any licenses and/or certifications? (List Name, Date Certified, Expiration for each. )
NAME OF CERTIFICATION DATE CERTIFIED/LICENSED: EXPIRATION (IF APPLICABLE):
CPR Month: 4
Day: 8
Year: 1955
Month:5
Day: 6
Year: 1958
DSSA Month: 2
Day: 4
Year: 1953
Month:3
Day: 9
Year: 1956
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Q11. Have you ever been convicted of a crime?



Q12. Do you have any pending litigation?



Q13. If you answered yes to questions #11 and/or #12, please explain. (include year of conviction and/or pending litigation).


Q14. Have you ever served in the military?



Q15. If you answered yes to question #14, in which branch did you serve?
(Ex. AIR FORCE, ARMY, NAVY, MARINES, COAST GUARD, NATIONAL GUARD)
NAME BRANCH OF SERVICE HIGHEST RANK DATE ENTERED: DATE DISCHARGED: TYPE OF DISCHARGED: DD214 NUMBER:
1 - Army Month: 9
Day: 25
Year: 1959 		Month:9
Day:26
Year:1965 		Honorable 8378337
2 - Navy Month: 3
Day: 6
Year: 1960 		Month:4
Day:6
Year:1963 		Administrative 84848484
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