The Next Step - Transition Program
 
The Next Step - Transition Program
Name
Mailing Address
City
State
Zip Code
Cell Phone Number
Your Email Address  * 
Year Graduating from High School or Equivalent
Birthdate
Age
Marital Status
If married, for how long?
Name of Father or Guardian
Name of Mother or Guardian
How would you describe your health?
List any known drug allergies
List any physical limitations
List any current medications you are taking
Have you ever used illegal drugs?
If yes, date of last use
Have you ever smoked tobacco?
If yes, date of last use
Have you ever used alcoholic beverages?
If yes, date of last use
Are you currently employed?
If yes, who is your present employer?
What is your position?
Date Hired
Past Employer
What was your position?
Date Hired
How did this job end?
Date Ended
How do you plan to pay for your tuition?
Will you have the total amount by the required date?
If no, please explain
Will you have access to transportation?
Name of Home Church
Denomination
Church City
Church State
Phone Number
Name of Senior Pastor
Name of Youth Pastor
How long have you attended this church?
List the different ministries in which you are presently involved:
When did you become a believer in Christ?
Where?
How many times a week do you attend church?
How do your parents/guardians feel about your participation in The Next Step?
 
 
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