Canvas Leadership Track Application

Personal Information

First Name *

Last Name *

Date of Birth *

Email Address *

Phone Number *

Home Address *

Home City *

Home State *

Home Zip Code *

Marital Status *

Date of Marriage (if applicable)

Present Ocupation *

Work Phone

Health

Do you have any health concerns that SoM should know about?

Church Information

How long have you attended Canvas Church? *

Date that you accepted Jesus Christ as Savior

Have you been water baptized?

Yes

Date

Have you received the baptism of the Holy Spirit?

Yes

Date

Have you ever taken Bible Classes or Leadership Classes before?

If Yes, please list the classes you have taken and where you took them at.

Academic History

List the colleges, universities or other schools you have attended

Name

Diploma/Degree

Dates

Location

GPA

Name

Diploma/Degree

Dates

Location

GPA

Name

Diploma/Degree

Dates

Location

GPA

References

List names, addresses & telephone numbers of two persons (unrelated adult Christians aside from your Pastor)

Name *

Address

Phone *

Name *

Address

Phone *