REPEATING FIRST/SECOND

2022 APPLICATION

Personal Information

First Name *

Last Name *

Age *

Phone Number *

Email Address *

Confirm Email Address *

Are you transferring from another SSM School? If so, what year(s) did you complete at your previous SSM School? *

Yes

No

Gender *

Male

Female

Relationship Status *

Single

Married

Divorced

Widowed

If married, will your spouse be attending the school as well?

Yes

No

If separated or divorced, please provide an explanation for each marriage or divorce:

Will you be repeating 1st Year or 2nd Year? *

1st Year

2nd Year

SSM EXPERIENCE

Briefly describe your reason for repeating either 1st year or 2nd year *

What two areas have impacted you the most from your 1st or 2nd year experience? *

What two areas have you been challenged in the most? *

What two areas have you grown in the most? *

What are you really passionate about? *

Do you attend church regularly? *

Yes

No

If no, please give details as to why not

Health

Please describe any physical or emotional conditions and state any special attention, treatment, or medication required: *

Emergency Contact Name: *

Emergency Contact Number: *

Revivalist Lifestyle

Answering yes to the following questions will NOT automatically disqualify you from participating in the School

In the last year have you abused tobacco, alcohol, drugs, illegal substances, or pharmaceutical drugs? *

Yes

No

If yes, please explain:

Have you been involved with pornography in the last 12 months? *

Yes

No

If so, when was the last time and what have you been doing to remain pure in this area?

Have you engaged in homosexual activity in the last 5 years? *

Yes

No

If so, when was the last time? And please explain what God has done to restore you:

Are you currently in a sexual relationship with someone to whom you are not married? *

Yes

No

Have you ever been arrested? *

Yes

No

If yes, when? Please provide a brief explanation:

Have you ever been convicted of a misdemeanor or a felony? *

Yes

No

If yes, when? Please provide a brief explanation:

Have you ever been involved in witchcraft, the occult, or satanism? *

Yes

No

If yes, when? Please provide a brief explanation:

Have you ever been diagnosed with a mental health issue or disease? Including, bipolar disorder, schizophrenia, Borderline Personality Disorder, Psychopathy, Sociopathy, etc. *

Yes

No

If yes, when? Please provide a brief explanation:

Employment

Employment (Employer may be contacted)

Current occupation

Employer's name

Street Address

City

State

Zip Code

Phone Number (Format: 1234567891... No parentheses or dashes needed)

WORSHIP

ESSM will have student lead worship teams. Do you have experience leading worship vocally or with instrument? Please share below your vocal or instrument abilities and experience: *

SERVING

As an ESSM student you will have opportunities to stretch and grow as a servant leader, not only in the school, but also at our local church, Pathway. Please check below any areas you have a desire to help serve: *

Thank you for your interest in applying for Encounter School of Supernatural Ministry. We look forward to reviewing your application. Please remember to have your personal and pastoral recommendations fill out their respective forms at essmtx/org.

Before paying your application fee and submiting your form, please make sure to review your application.

Agreement: I understand that any falsification of information on this application is grounds for dismissal at any time. I hereby certify that I have read the Encounter School of Supernatural Ministry application and completed it with integrity. Please sign below to complete your application - if there is no signature, it does not alert us that you have applied. If you have any technical difficulties with the application, please contact Camila@thepathwaychurch.org *

clear

Thank you for taking the time to fill out this application!

Upon submitting this form, you will be directed to the (non-refundable) application fee link. Please note:

Until May 24th	EXISTING STUDENTS	$21
May 25th-August 20th	FIRST-TIME and EXISTING STUDENTS	$43
August 21st and on	All STUDENTS	$83

To complete your application, please pay the application fee.