Project Antioch 2024-2025 Application for Admission
Thank you for your interest in learning more about the Project Antioch Gap Year Program! Please take the time to fill out each section of this application completely. Thank you for your interest in the 2024-2025 class of Project Antioch.
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Name: Last, First, M. Initial *
Date of Birth *
Gender *
Do you have a Drivers License? If no, why not? *
License State and Number *
Current Life Situation *
Address *
Home Phone *
Cell Phone *
Email Address *
Social Security Number (If US Citizen) *
Parent/Guardian Name: Last, First *
Parent/Guardian Email Address *
Parent/Guardian Name: Last, First *
Parent/Guardian Email Address *
Parent/Guardian Address *
Have you been baptized? If so, when? *
What best describes your spiritual life right now? *
Explain your answer *
Were you raised in the church? *
Name of Home Congregation *
Address of Home Congregation *
Are your parents Christian? *
Do your parents approve of you joining Project Antioch? *
Are your parents *
How long? *
Describe your present relationship with your immediate family. *
How did you hear about Project Antioch? *
Have you ever been on a mission trip? *
If yes, who lead the trip, where did you go, how long were you there, and what is your leaders contact information? *
Explain the work/service you participated in: *
Do you have a valid passport? *
If yes, what is your passport number? *
Please locate the NWSD Statement of Faith on our website. Do you agree with it? If not, please describe the areas of disagreement: *
How involved are you currently with your church? *
What other leadership or service roles are you involved with? *
Are there any other extra-curricular activities you are doing? *
What are your academic interests? What is your High School GPA? *
Do you currently have any disabilities we should know about that could hinder your participation? *
Have you had any life struggles that we should know about (abuse, crime, major medical issue, drug use, tragedy, etc.)? We will hold this confidentially but we want to know about your life. Tell us about anything that you’ve had to overcome up to today. What did you do or are currently doing to move beyond these things? *
What excites you the most about Project Antioch? *
Required
What are some things you do to grow in your faith? *
Have you ever had a mentor? What lessons have they taught you? What kind of mentor would you like to have? *
What do you hope to achieve by participating in Project Antioch? *
Project Antioch is a life-changing experience. However, because of our focus, it is also very demanding. Students will be held to high standards in their studies, their service, and their moral character. Having life struggles in your background does not necessarily disqualify you from being part of Project Antioch, but we do want you to know of the high expectations. Are you ready to join us for this intensive experience? (Answer, and please digitally sign your name by typing your full name) *
Project Antioch is a life-changing experience. However, because of our focus, it is also very demanding. Students will be held to high standards in their studies, their service, and their moral character. Having life struggles in your background does not necessarily disqualify you from being part of Project Antioch, but we do want you to know of the high expectations. Are you ready to join us for this intensive experience? (Answer, and please digitally sign your name by typing your full name) *
Character References 
List the name, title, and contact information for at least three references (the first three). By signing below you give us permission to talk to these individuals about your character, giftedness, church involvement, and other things relevant to your participation with Project Antioch.
REFERENCE #1: Teacher or Mentor: (Name, Contact Phone, Title, Email)
REFERENCE #2: The Minister of your home congregation:  (Name, Contact Phone, Title, Email)
REFERENCE #3: An Elder in your home congregation (if no elders, indicate another leader):  (Name, Contact Phone, Title, Email)
REFERENCE #4 (optional): Friend or Family member of your choosing:  (Name, Contact Phone, Title, Email)
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