Submerge Application

Please make sure you have 15-20 minutes to fill out this application before you begin as you can not save your answers and continue later. Be sure to have the phone number for the following references; friend, employer, pastor/spiritual leader. After you have successfully completed the application, click the link provided on the confirmation page to pay the $35 application fee.

Name

First Name

Last Name

Submerge Session You Wish to Attend.

Sex

Male

Female

Email Address

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Date of Birth

YYYY

Have you traveled to another country before? If yes, please provide a brief description of your overseas experience.

Please provide a brief overview of your educational history.

If accepted to Submerge, what is it that you hope to get out of the program?

Describe your current relationship with God.

Why do you want to be part of Submerge?

Why do you believe you would be a good candidate for the Submerge program?

Please List 3 strengths you feel you possess

List 3 areas you consider to be weaknesses.

If you checked "yes" to any of the items above please provide a brief description for each.

References

Please provide the following 3 references; friend, employer, pastor/spiritual leader.

Friend

First Name

Last Name

Friend Phone

(###)

###

####

Employer

First Name

Last Name

Employer Phone

(###)

###

####

Pastor/Spiritual Leader

First Name

Last Name

Pastor/Spiritual Leader Phone

(###)

###

####

Thank you for applying to Submerge! In order to complete your application please CLICK HERE to pay your $35 application fee.