IPAW Student Application Form

Name(Required)

First Middle Last

Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Cell Phone(Required)

Home Phone

Email(Required)

Date of Birth(Required)

Are you over 18 years of age?

Yes

Do you have the consent of your parents or legal guardian?

Yes

How long have you been a Christian?(Required)

How old were you when you first believed you were called into ministry?(Required)

In about 30 words or less, please tell us why you feel you are called into the ministry?(Required)

Is your Pastor in agreement for you to enroll in IPAW?

Yes

Pastor's Name

Prefix First Last

Church Name

Church Address

Street Address City State / Province / Region ZIP / Postal Code

Pastor's Cell Number

Church Office Phone

A Pastor’s recommendation in 30 words or less:

IPAW Student's Electronic Signature(Required)

By signing with your electronic signature you agree that it has the same legal validity as if you were signing by hand. Please place your initials between two forward slash symbols: ex. /ABC/

Date(Required)

Pastor's Electronic Signature

By signing with your electronic signature you agree that it has the same legal validity as if you were signing by hand. Please place your initials between two forward slash symbols: ex. /ABC/

Date

Parent’s or Legal Guardian’s Electronic Signature

By signing with your electronic signature you agree that it has the same legal validity as if you were signing by hand. Please place your initials between two forward slash symbols: ex. /ABC/

Date

I agree to receiving marketing and promotional materials.

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