Participant Application
PLEASE READ: Our Fall 2022 program will be a 10 week program, lasting from September 8-November 10. 

We'll meet one night each week to eat together, study the Bible, and learn job & life skills. You will also be paired with an encourager who will walk alongside you to help you meet your goals.

Dinner and childcare will be provided.

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Name *
Address, City, State, Zip Code *
Phone number where you can be reached *
Birthdate *
MM
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DD
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YYYY
Are you: *
If married, please provide husband's name
Who lives in the same house with you? Please provide name, age, and relationship of all household members. *
What grade did you complete?    When (Year)? *
Do you go to church? *
If you attend church, where do you go? *
Where have you worked (begin with the latest). Please include employer, your job and Date Ended. *
What is your source of income? *
Of all your jobs, which one did you like best? Why? *
What are you good at? What do you like to do? *
How did you hear about Restoration Women? *
Do you have someone you can confide in? *
Are there any circumstances in your life that may create problems for you while participating in the ministry? *
How do you think Restoration Women can help you? *
Please give 3 references we may contact, including name, phone number, email if possible. *
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