Apply Now! | Immersion Discipleship House

How did you hear about Immersion Discipleship Home?*

Why do you want to apply to Immersion Discipleship Home?*

Name*

Email*

Phone Number:*

Current Address:*

Birthdate:*

Gender:*

Male

Female

Marital Status:*

Single, never married

Single, divorced

Married

Widowed

Separated

Parent 1 Name:*

Parent 2 Name:*

Address:*

Parent 1 Phone Number:*

Parent 2 Phone Number:*

Additional parental contact info if parents don't reside together:

Home Church name and city:*

Senior Pastor name and contact info*

Number of years attending:*

Please list any service or leadership experiences within the church or ministries?:

Check all that apply to you in regards to your educational status:*

Never graduated High School

Graduated High School/Earned High School Diploma/GED

Currently in/going into my first year of college

Currently in/going into my first second of collegeOption 4

Currently in/going into my third year of college

Currently in/going into my forth year of collegeOption 6

Currently in/going into my fifth year of college

Graduated college

Not in school

Other

Check all that apply to you in regards to your vocational status:*

Never had a job

Not looking for a job

Currently looking for a job

Currently working

Other

Do you have any chronic diseases or physical limitations which might require special consideration or facilities? If so, please explain.*

Do you have a history of mental illness? If so, please explain:*

Do you have a criminal record? If so, what for?*

Do you have any allergies (food, medication, etc.) which might require special consideration or facilities? If so, please explain.*

Do you use tobacco or drink alcohol? Are you using other drugs/intoxicants? Please write about your experience with this:*

Tell us about your walk with the Lord. When did you get saved? How did it look? What does your devotional life look like? *

Please inform us of how you would be able to financially support your time here (Parents are paying, you plan on supporting yourself through working, etc.):*

Have you lived in a community environment before? If so, please tell us about your experience:*

Are you willing to room with 2 or 3 other people? If so, please tell us about your sleeping habits, such as if you sleep with a fan on/need white noise, prefer rooming with someone that stays up late or wakes up early, etc. We want to ensure residents have compatible roommates.*

Would you be able to commit to Immersion Discipleship Home's schedule? *

By checking yes, I am agreeing to the policies set forth from the Code of Conduct page and give my permission to complete a background check.*

Yes

No

In addition to your application, please submit 1 pastoral reference and 2 personal references. *

NEW RESIDENT APPLICATION

We are a discipleship community for young adults seeking to be immersed in God's presence,

His Word,

and His works.

We'd love to connect with you!