IPAW Student Application Form

Name*
First Middle Last
Address*
Street Address City State / Province / Region ZIP / Postal Code
Cell Phone*
Home Phone
Email*
Date of Birth*
Date Format: MM slash DD slash YYYY
Are you over 18 years of age?
- Yes
- No
Do you have the consent of your parents or legal guardian?
- Yes
- No
How long have you been a Christian?*
How old were you when you first believed you were called into ministry?*
In about 30 words or less, please tell us why you feel you are called into the ministry?*
Is your Pastor in agreement for you to enroll in IPAW?
- Yes
- No
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*
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*
Date Format: MM slash DD slash YYYY
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
Date Format: MM slash DD slash YYYY
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
Date Format: MM slash DD slash YYYY
- I agree to receiving marketing and promotional materials.