APPLICATION FOR ENROLLMENT

Please fill out the form completely. You will receive an email within one week to confirm that your application was received and to set up an interview.  

Personal Information
Name *
Name
Cell Phone *
Cell Phone
Address *
Address
Gender *
Date of Birth *
Date of Birth
Academic Information
Enrollment Term *
Is your age at least 18? *
Have you ever been convicted of a crime other than a minor traffic violation? *
Are you currently enrolled at a college/university? *
Leadership Focus
Pastoral Reference
Name *
Name
Relationship
Personal Reference
Name *
Name
One Minute Video
If you do not currently attend River Valley Church, you must record and submit a one (1) minute video to complete the application process. Tell us why you would like to be a part of the Leadership Institute and why you should be selected. (Videos should be recorded and uploaded to a media site such as YouTube or Vimeo.) Please include the link in the space below.
http://