Hezekiah Project—Student Application

Student Application

There is a $25 Application Fee upon submission. You will be redirected to PayPal for payment.
This is non-refundable, but will be applied to your tuition upon acceptance to the program. Any applications submitted without a corresponding payment will not be considered.

STUDENT APPLICATION

Name (First & Last)

Phone

Street Address

City

Region/State/Province

Postal / Zip code

Birthday

Parent or Legal Guardian 1 Full Name

Phone

Parent or Legal Guardian 2 Full Name

Phone

Do you have any dietary restrictions?

Do you have any medical conditions of which we need to be aware?

If so, where?

If not, please explain.

If so, please explain.

Please share that experience, along with any other parts of your testimony you would like to share.

How does your relationship with God affect your life?

What do you think are the most important qualities of a strong Christian leader?

How do you practice spiritual disciplines in your daily life (prayer, worship, reading your Bible, etc.)?

What are your strengths and weaknesses, and what do you hope to gain by being a part of the Hezekiah Project?

References

We require 3 references, one of which must be from a pastor. We will reach out to these references directly.

REFERENCE 1 Name

How do you know this person?

Phone

REFERENCE 2 Name

How do you know this person?

Phone

PASTORAL REFERENCE Name

How do you know this person?

Phone

Local Sponsor

Do you know anyone who would commit to support you throughout this program? This would involve checking in on you, providing transportation when needed, helping you achieve your service hours, etc. (this person could be a parent/guardian, pastor, teacher, mentor, etc.)

Local Sponsor Name

How do you know this person?

Phone

I have watched the Tuition Information video above.

I have read the Core Values/Code of Conduct for the Hezekiah Project, and I understand that I will be held accountable to those standards.View Core Values/Code of Conduct

PARENT/LEGAL GUARDIAN SIGNATURE. By signing below, I give permission for my child to apply for and participate in the Hezekiah Poject. I acknowledge that they have agreed to the above Core Values and Code of Conduct, and I will commit to support their decision by helping them uphold their commitment.

Student Application

There is a $25 Application Fee upon submission. You will be redirected to PayPal for payment. This is non-refundable, but will be applied to your tuition upon acceptance to the program. Any applications submitted without a corresponding payment will not be considered.

STUDENT APPLICATION

References

Local Sponsor

There is a $25 Application Fee upon submission. You will be redirected to PayPal for payment.
This is non-refundable, but will be applied to your tuition upon acceptance to the program. Any applications submitted without a corresponding payment will not be considered.