CCSC - 2019 Vocation Project Application
To the best of your ability, please fill out this form entirely. The deadline for a submitted application is March 15, 2019. If you have any questions, feel free to call the CCSC office at 434-296-3333.
BASIC INFORMATION:
Title:
Your answer
First Name (Legal Name): *
Your answer
Middle Initial (Legal Name):
Your answer
Last Name (Legal Name): *
Your answer
Suffix:
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Nickname:
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Street Address: *
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City: *
Your answer
State/Province: *
Your answer
ZIP/Postal Code: *
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Country: *
Your answer
Address at School (if different)
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Cell Phone: *
Your answer
Alternate Phone:
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Email: *
Your answer
Twitter:
Your answer
Facebook:
Your answer
Gender: *
Do you self identify as: *
If Christian, what is the full name of your denomination? *
Your answer
Do you self identify as: *
Are You: *
Required
If you are not a U.S. Citizen, please state your nationality and the circumstances surrounding your presence in the U.S.
Your answer
Date of Birth: *
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Place of Birth: (City, State/Province, Country) *
Your answer
EDUCATION INFORMATION:
Are you currently: *
Required
What year of your current program are you in (e.g. undergrad sophomore, first year grad, etc.) *
Your answer
What was/is your undergraduate major(s)? *
Your answer
If a graduate student, briefly describe your graduate research:
Your answer
List all universities, colleges, and other schools of higher education you have attended, including any for summer or special courses. Please list those from which you have received degrees in descending order of significance, highest degree first. You will have space to list 6 schools.
1. College, University, or other School of Higher Education *
Your answer
1. Degree & Major *
Your answer
1. Grad Year *
Your answer
2. College, University, or other School of Higher Education
Your answer
2. Degree & Major
Your answer
2. Grad Year
Your answer
3. College, University, or other School of Higher Education
Your answer
3. Degree & Major
Your answer
3. Grad Year
Your answer
4. College, University, or other School of Higher Education
Your answer
4. Degree & Major
Your answer
4. Grad Year
Your answer
5. College, University, or other School of Higher Education
Your answer
5. Degree & Major
Your answer
5. Grad Year
Your answer
6. College, University, or other School of Higher Education
Your answer
6. Degree & Major
Your answer
6. Grad Year
Your answer
List any awards, honors, or scholarships you have received in the past four years. Please list in descending order of significance. You have space to list up to 4 awards.
1. Name of Award
Your answer
1. Date
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1. Description
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2. Name of Award
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2. Date
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2. Description
Your answer
3. Name of Award
Your answer
3. Date
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3. Description
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4. Name of Award
Your answer
4. Date
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4. Description
Your answer
WHY DO YOU WANT TO DO THIS PROGRAM?
With what Christian Study Center(s) have you been most closely affiliated? (If none, enter DNA) *
Your answer
Describe the history of your relationship with that/those Study Center(s) (If none, enter DNA): *
Your answer
Name(s), email address(es), and cell phone number(s) of the staff person(s) whom you know best at the Study Center(s) (If none, enter DNA): *
Your answer
In one paragraph, please describe your career goal. *
Your answer
In no more than two paragraphs, please describe why you want to be part of the Consortium of Christian Study Centers 2019 Vocation Project? *
Your answer
Visit the Regent College Summer School webpage (http://www.regent-college.edu/summer/courses/summer) and look for the courses you would like to take, listing them by name, course number, and instructor. (No more than one course per week, please.)
Week One Course (July 15-19) *
Your answer
Week Two Course (July 22-26) *
Your answer
What additional information (not already addressed in the application) do you wish to share with the Consortium of Christian Study Centers' scholarship review committee? *
Your answer
I understand and affirm that I am applying for a scholarship to the Consortium of Christian Study Centers 2019 Vocation Project. I also have read, understand, and affirm the policies and regulations associated with this scholarship. I understand that this application will be available only to qualified people who need to see it in the course of their duties. This application is my own work, and I affirm that the information contained herein is true and accurate to the best of my knowledge and belief.
Electronic Signature *
Your answer
Date of Signature *
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Thank you!
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