focusone.com | Online Application

First Name *
Last Name *
Email *
Address *
Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Cell Phone Number *(###) - ### - ####
Home Phone Number(###) - ### - ####
Birth Date *
Social Security Number *###-##-####
Marital Status *
If married, how long?
Year of High School Graduation *
T-shirt Size *
How did you hear about Focus One? *

Name of Father / Guardian
Address of Father / Guardian
Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Has your Father / Guardian accepted Christ?
Father / Guardian's Occupation
Name of Mother / Guardian
Address of Mother / Guardian
Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Has your Mother / Guardian accepted Christ?
Mother / Guardian's Occupation
How do your parents / guardians feel about you coming to Focus One?

Are you currently employed?
Current Employer
Position with Current Employer
Date Hired by Current Employer
Previous Employer
Position with Previous Employer
Date Hired by Previous Employer
Date Employment Ended with Previous Employer
Reason for Leaving (2 of 2)
How do you plan to pay for your tuition?
Will you have the total amount by the start of Focus One?
If no, please explain
Do you have your own vehicle?(required upon entrance)
Do you have health insurance?(required upon entrance)
List any debts, loans, or payments that you presently owe, including the amounts due for each
Will your debts be paid off by the start of Focus One?
If no, how will you make payments?

Name of Home Church
Denomination
Address of Home Church
Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Name of Lead Pastor
Name of Youth Pastor
How long have you attended this church?
Are you a member of this church?
List the different ministries you are presently involved in
When did you accept Christ?
Where did you accept Christ?
Have you been baptized in water
Have you ever had an Acts 2:4 experience?
How many times a week do you attend church?

Name of Reference (1 of 3)
Relationship to Reference (1 of 3)
Phone Number of Reference (1 of 3)
Name of Reference (2 of 3)
Relationship to Reference (2 of 3)
Number of Reference (2 of 3)
Name of Reference (3 of 3)
Relationship to Reference (3 of 3)
Phone Number of Reference (3 of 3)