Application for

Admission

Personal Information

Name: ______________________________________________________________________________________________________
first middle last
Mailing
Address: ____________________________________________________________________________________________________
street

____________________________________________________________________________________________________________  
city state zip/postal code country

Phone (include area code): ______________________________________________________________________________________

Email: ______________________________________________________________________________________________________

Gender: q Male q Female Date of Birth: __________/_________/__________

Is English your first language: q Yes q No

Please list any languages in addition to English that you speak fluently: __________________________________________________

Are you a student of Southern Adventist University? qYes qNo

If you are a student at any college/university, what is your major? ____________________________

Class Standing: q Fr q So q Jr q Sr

Family Information

Marital Status: q Single q Married q Separated q Divorced q Widowed

Spouse’s Name: __________________________________ Spouse’s Date of Birth: __________/_________/__________

Do you have children? q Yes q No If so, how many? _______ What are their ages? __________________

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Education History

Please list your previous education/training:

Have you ever been dismissed from any educational institution? q Yes q No (If so, please attach an explanation)

Spiritual Information

Church Affiliation: _____________________________________________ Are you a baptized member? q Yes q No

Baptismal Date: __________/_________/__________

Local Church Membership: __________________________________ Church Phone Number: _________________________

Name of Pastor: ____________________________________________ Pastor’s Phone Number: __________________________

What is your main objective in attending SEYC Summer of Evangelism? ________________________________________________

____________________________________________________________________________________________________________  

____________________________________________________________________________________________________________  

Define/describe your present spiritual condition: ____________________________________________________________________

____________________________________________________________________________________________________________  

____________________________________________________________________________________________________________  

____________________________________________________________________________________________________________  

How would you describe your knowledge of the Bible? ______________________________________________________________

____________________________________________________________________________________________________________  

____________________________________________________________________________________________________________  

Rate your understanding of the fundamental beliefs and practices of the Seventh-day Adventist Church: q 1 q 2 q 3 q 4 q 5
(1= no understanding, 2= low understanding, 3= general understanding, 4= high understanding, 5= complete understanding)

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Are you in agreement with them? q Yes q No (If not, please attach an explanation)

Have you ever done door-to-door ministry? q Yes q No Have you had any special training in soul winning? q Yes q No

Please describe any previous training and/or experience in soul winning: _________________________________________________

____________________________________________________________________________________________________________  

____________________________________________________________________________________________________________  

____________________________________________________________________________________________________________  

Other Information

How did you hear about SEYC Summer of Evangelism? _____________________________________________________________

____________________________________________________________________________________________________________  

List your hobbies and/or leisure activities: _________________________________________________________________________

____________________________________________________________________________________________________________  

Please list favorite authors or public speakers and why you particularly like them: _________________________________________

____________________________________________________________________________________________________________

____________________________________________________________________________________________________________  

Are you bringing a vehicle with you? q Yes q No Are you willing to have others carpool with you for outreach? q Yes q No

Will you need to be picked up from the airport at the beginning of the program? q No q Yes __________________ (Airport Name)

Will you need to be dropped off at the airport at the end of the program? q No q Yes __________________ (Airport Name)

Have you ever been convicted of a crime other than a traffic violation? q Yes q No (If so, please attach an explanation)

References

Please provide three references (pastor, work supervisor, other non-family member):
Reference Name Phone Number Relation to You How Long Acquainted

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Academic Credit Options

The School of Religion at Southern Adventist University (SAU) is providing three semester hours of academic credit for those who
want/need it. Upon acceptance, more information will be given regarding student registration through SAU.
Please select the academic credit option you are interest in:
q No Credit
q RELP 264 – Christian Witnessing (3 credits)*

*NOTE: If you are not a currently enrolled student of SAU and you are seeking academic credit, then an application to SAU must be
filled out and submitted in addition to this application. Applications can be acquired from SAU’s Admissions Office or from the
website, http://www.southern.edu.

Costs

Upon notification of acceptance to the program, a $50 commitment deposit must be submitted to reserve your place. This deposit
will be used towards your program fee, the remainder of which is due on or before registration (July 24). Spaces will be filled on a
first come first served basis.
The date we receive your commitment deposit determines whether you qualify for early, standard, or late registration rates!
For non-academic credit participants:
• Program fee only (paid to SEYC directly)
• Early Registration (on or before April 15): $300
• Standard Registration (April 16 - May 15): $325
• Late Registration (May 16 – July 1): $350
For those registering for academic credit through Southern Adventist University:
• Regular Southern summer tuition or free tuition for Smart Start students*
• PLUS $50 program fee (paid to SEYC directly)

*Plus SAU tuition if applicable. If you are seeking academic credit, tuition will be billed separately by SAU. 2011 summer tuition
rates are $568 per credit hour. However, if you are a first time SAU student, tuition may be free under the Smart Start program!
Visit http://www.southern.edu for more information.

Applicant’s Initials & Signature

Please read and initial the following:

___ I understand that full payment for this summer program is due on or before Registration and that my space in the program will
not be reserved until I am accepted and submit my $50 commitment deposit.

___ I certify that all of the information that I have supplied on this application is true and correct. I realize that falsification of any
information I provide to SEYC Summer of Evangelism is grounds for immediate dismissal, without refund.

____________________________________________________________________________________________________________
Signature Date Print Name

 
Applications can be returned to: SEYC Summer of Evangelism
c/o Evangelistic Resource Center, Southern Adventist University, P.O. Box 370, Collegedale, TN 37315
Phone: 423-615-9537 Fax: 423-236-1976 Email: [email protected]
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