Application for SEU at Victory Church

Name *
Address *
Phone *
Birthdate *
Emergency Contact
Contact Name *
Contact Name
Contact Phone *
Contact Phone
Contact Address *
Contact Address
Family information
Father's Name *
Father's Name
Father's Address
Father's Address
Required if different than applicant.
Father's Phone Number *
Father's Phone Number
Is your father living? *
Is your father a Christian? *
Mother's Name *
Mother's Name
Mother's Address
Mother's Address
Required if different than applicant.
Mother's Phone Number *
Mother's Phone Number
Is your mother living? *
Is your mother a Christian? *
Educational Background
Are you interested in campus dorms? *
Limited housing will be made available at an additional costs.
Behavior History
Christian Experience
Have you received the Baptism of the Holy Spirit according to Acts 2:4? *
Church Address *
Church Address
By checking this box, I am certifying that the information supplied on this application is true and complete. Any falsification or omission of information may be grounds for denial of admission or for dismissal. *