Hope Corps Application Form APPLICATION - Hope Corps Application Please Note: Students who complete this application will be enrolled in Wilson University and registered to complete the Apostolic Foundations Certificate program. By signing this form you agree to accept all responsibilities and fees associated with this program. After completing the courses at Wilson University, students must complete an Intensive Training Week to graduate to alumni status. Please note that a background check is required to attend. Personal InformationName* First Middle Last Name you prefer to go by if different than first name Mailing Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSaint MartinSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Phone #*Mobile Phone #Email* Enter Email Confirm Email Social Security Number*Date of Birth* Picture of Applicant*Accepted file types: jpg, jpeg.Please upload a HEAD SHOT picture of your self. Marital Status*SingleMarriedDivorcedSeparatedWidowGender*MaleFemaleEthnic Group*WhiteAmerican-IndianBlack/African AmericanHispanic/LatinoAsian or Pacific IslanderCitizen*US CitizenResident AlienNon-CitizenPrevious Education*High School Senior CurrentlyHigh School GraduateGEDSome CollegeBachelor's DegreePost-Graduate (Masters, Doctorate)What language do you prefer to take your course in?*EnglishEspañolPersonal HistoryPastor's Name* Church Name*Pastor’s Telephone Number*Pastor's Email* Have you received the baptism of the Holy Ghost evidenced by speaking with other tongues?*YesNoHave you been baptized in the name of Jesus Christ for the remission of sins?*YesNoHave you ever been convicted of a sex related crime (i.e. assault, rape, possession of child pornography)?*YesNoPlease explain*Do you currently or have you ever had an issue with mental or behavioral problems?*YesNoPlease explain*Do you have a history of medical issues which would prevent you from participating in the program?*YesNoPlease explain*Please provide a brief description of yourself. ( no longer visible on form)*How did you hear about Hope Corps?*Holy Ghost RadioHope Corps AlumniIBC PerspectivesPastorPEAKSocial MediaTogether MagazineHope Corps AlumniPlease enter the name of the alumnus who referred you to Hope Corps. First Last What are your reasons for joining Hope Corps? (no longer visible on form)*Commitment, Disclaimer and SignatureI hereby certify that the information contained in this application is accurate and complete to the best of my knowledge. If admitted to Wilson University, I commit myself to abide by all rules and regulations of the University, whether academic or disciplinary, to conduct myself at all times in keeping with the purpose of the university, and to apply myself to study and to fulfill the course requirements to the best of my ability. I understand that all admissions materials or information submitted becomes the property of the college and are not returnable. Additionally, I agree to maintain and uphold the standards held by Hope Corps and its affiliated partners. I commit to one hour of daily prayer and Bible reading and will submit to the authority of my pastor and other ministry staff. Student Name* Student Name Date* Signature*PLEASE BE ADVISED that this application will not be processed until Hope Corps receives your pastor's approval form. The pastor's approval form is sent automatically to the e-mail you provided for your pastor in the pastor's e-mail field on this application. Hope Corps Application FeeBypass Payment Code If you already paid your Hope Corps Fee in the past year you can obtain a code from [email protected] to use here to bypass paymentHope Corps Application Fee $0.00 Credit Card* American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20192020202120222023202420252026202720282029203020312032203320342035203620372038 Expiration Date Security Code Cardholder Name This iframe contains the logic required to handle Ajax powered Gravity Forms.
