Advanced Application

Instructions

Complete the following questionnaire in detail. All answers will be kept strictly confidential. We do not discriminate our admission based on race, color, national, or ethnic origin. These questions help us better understand who you are and how to make Advanced meet your needs.

First Name

Last Name

Middle Name

Birthday

Nickname/Alias

Address

Address Line 2

City

State

Zip

Country

Phone Number

Type

Picture of Yourself (taken in the last year)

Family Information

Parents' Names

Family Email

Phone Number

Type

Siblings' names and ages

What is your parent's marital history?

Explain your relationship with your parents

Are you adopted?

Yes No

Are you a foster child?

Yes No

About You

What books have you read in the past six months?

Have you ever been evaluated for a learning disability?

Yes No

Explain what you were evaluated for

Is there someone in your life with whom you could be emotionally honest right now (i.e. you could tell this person exactly how you feel about yourself, life, and other people)?

Yes No

If you could change anything about yourself what would it be and why?

What would you consider your strengths in life?

1 John 5:11-12 says, "God gave us eternal life, and this life is in his Son. Whoever has the Son has life; whoever does not have the Son of God does not have life." Do you have the Son of God in your life?

Yes No

Explain how and when you became a believer and on what you base your hope of salvation

Are you plagued with doubts concerning your salvation?

Yes No

Do you have a regular devotion time in prayer and the Bible?

Yes No

What is your greatest struggle in your walk with the Lord?

Is it your choice to attend Advanced?

Yes No

Dietary Restrictions

No Restrictions Gluten Free Dairy Free Other

Details about your dietary restrictions

I affirm that I have filled out this application honestly and to the best of my ability

Full Name

Date

Please have one of your parents or legal guardian complete the following questions.

How would you describe your relationship with your daughter?

What life values would you like to see developed in your daughter's life during Advanced?

List any other information that you feel would help us understand and offer help to your daughter?

I affirm this section to be true to the best of my knowledge

Full Name

Date