MLC // Application for Midwest Leadership College

Your name *

Last name

Email address *

Personal Information

Phone number *

Phone type

Address *

Country

Street Address

Apt/unit/box (optional)

City

State

Postal code

Birthdate *

Gender *

Marital status *

Academic Information

How did you hear about MLC? *

Are you a new guest at Evangel?

Yes

When are you hoping to begin *

Preferred Practicum Track *

Please indicate the practicum track for which you would like to enroll. Each practicum requires a minimum of 20 hours per week.
(Some tracks cap out at a certain number of students, so please choose your top 2).

Evangel Kids

Evangel Youth

Evangel Worship

Evangel Production

Creative

Discipleship (Next Steps + Connections)

Community Life (Care + Reach)

Unsure

Young Adults

High School Graduation Year *

Are you currently enrolled in college? *

Yes

If yes, where?

If yes, what is your current class ranking?

Student Profile

Which church are you currently attending? *

How long have you been attending that church? *

1 year

2 years

3 years

4 years

5+ years

Have you surrendered your life to Jesus? *

Yes

Have you been water baptized by immersion as an adult? *

Yes

Have you received the baptism of the Holy Spirit with the evidence of speaking in tongues? *

Yes

In the last three years, have you used products containing nicotine? *

Yes

In the last three years, have you consumed alcohol? *

Yes

In the last three years, have you used any illegal or non-prescribed prescription drugs? *

Yes

In the last three years, have you been involved with sexual impurity? *

Yes

In the last three years, have you been involved in homosexuality? *

Yes

Have you ever been arrested? *

Yes

Have you ever been convicted of a felony? *

Yes

Are you currently on probation or parole? *

Yes

Please indicate if you have been treated for any of the following: *

Please check all that apply.

Emotional Instability [Depression, Bipolar Disorder, etc.]

Physical Problems

Trauma

Mental Illness

Eating Disorders

None of the above

List any major health problems:

Essays

Please respond with at least 300 words or we will reach out and kindly ask you resubmit your application.

Why are you seeking enrollment in the Midwest Leadership College? *

Please respond in at least 300 words.

What are your passions and life goals? *

Please respond in at least 300 words.

Pastoral Reference: Name *

Pastoral Reference : Phone Number *

Pastoral Reference: Email Address *

Personal Reference 1: Name *

Personal Reference 1: Phone Number *

Personal Reference 1: Email Address *

Personal Reference 2: Name *

Personal Reference 2: Phone Number *

Personal Reference 2: Email Address *

Did someone refer you to MLC? *

Yes

If yes, who?

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