Lakelight Institute Keller Fellowship Application

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All information will be kept strictly confidential and will be used solely for application purposes. If you have trouble with this form, please contact gwishnew@christchurchil.org

Name *

Email *

Are you applying to semester 1, semester 2, or both semesters of the Keller Fellowship? *

Semester 1

Semester 2

Both Semesters

Phone *

Address *

What church do you currently attend? *

Birthday *

YYYY

Gender *

Which of the following most accurately describe(s) you? *

Asian or Pacific Islander

Black or African American

Hispanic or Latino

Native American or Alaskan Native

White or Caucasian

Other:

Required

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