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REVIVE > Apply > Application Form 2019 (2nd Year)

Application Form 2019 (2nd Year)

* Denotes a required field.
  • Vital Information

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  • About You

  • Personal

  • Health

  • Employment (complete if changed jobs since last year)

  • (###) ###-####
  • Finances

  • Tuition is $2,495. Will you be able to pay tuition?
  • Pastoral Recommendation

    If you have changed churches since REVIVE First Year we require an updated Pastoral Recommendation be submitted as part of our application process.
  • Payment Information

  • Please Note*: Upon your acceptance to REVIVE, please complete and electronically submit the Financial Responsibility Form on our web site.
  • Billing Information

  • Agreement

  • I understand that any falsification of information on this application is grounds for dismissal at any time. I hereby certify that the information I have supplied herein is true.
  • This field is for validation purposes and should be left unchanged.
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