The Agora School
For Global Leadership
“The World is Your Campus”
Application For Admission
Please print or type your responses in black or blue ink. The entire application must be completed and returned to:
The Agora School, 6310 Hampstead Ave, Parma, Ohio 44129.
Phone: (954) 937-8230
The application process consists of the following required steps:
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Your completed application, including your personal statement/testimony.
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Application fee: $50. (Make your check payable to The Agora Group, Non-refundable.)
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Two completed Reference forms. Each prospective student will ask their pastor and one other individual (mentor, friend, teacher, etc. – references may not be a family member) to complete the reference form and mail it directly to The Agora Group.
Anticipated Enrollment:
__ Spring 2014 (deadline November 1, 2013)
__ Gay Olympic Game’s, Cleveland, OH (deadline May 1, 2014)
__ Iquitos, Peru (deadline May 1, 2014)
__ Alaska, USA (deadline April 1, 2014)
__ Fall 2014 (deadline July 1, 2014)
Enrollment Status:
__ Never attended college
__ Currently attending college at____________________________.
First Name: Middle Name: Last Name:
Address: Street Address:
Address Line 2:
City:
State:
Zip Code:
Home Phone:
Mobile Phone:
Work Phone:
Email Address:
Personal Information
Gender: ___ Male ___ Female
Birth Date:
Social Security Number:
Ethnic Group:
___ African American ___ American Indian
___ Caucasian/White ___ Hispanic/Latino
___ International Student ___ Asian
___ Native Hawaiian/Pacific Islander
___ Other
Are you a U.S. Citizen? ___ Yes ___ No Passport # _________
Marital Status: ___ Single ___ Married ___ Separated ___Divorced
Parent Information
Title: First: Last:
Father’s Phone Number:
Father’s Address: Street Address:
Address Line 2:
City:
State:
Zip Code:
Title: First: Last:
Mother’s Phone Number:
Mother’s Address: Street Address:
Address Line 2:
City:
State:
Zip Code:
Educational Background
Last High School Attended:
High School Address: Street Address:
Address Line 2:
City:
State:
Zip Code:
Type of Diploma: ___ H.S. Grad ___ GED___ High School GPA___
Date of H.S. Graduation:
Favorite Subjects:
Awards/Recognitions:
College/University attended (if applicable):
College City: College State:
Educational Goals:
___Bachelor (4-yr) ___Associate (2-yr) ___Non-Degree Seeking
Career Interest:
___ Creative Arts ___ Business ___ Pastoral Ministry
___ Student Ministry ___ Education ___ Social Work
___ Medicine ___ Missions ___ Other _________
Student Profile
Church Currently Attending:
Church Address: Street Address:
Address Line 2:
City:
State:
Zip Code:
Pastor’s First Name: Last Name:
Denomination:
How long have you been attending your church?
Have you accepted Jesus Christ as your Savior? ___ Yes ___ No
Do you strive to live a Christian lifestyle? ___ Yes ___ No
In the last year, have you used nicotine? ___ Yes ___ No
In the last year, have you used any illegal drugs, mind altering substances, or non-prescribed prescription drugs? ___Yes ___ No
In the last year, have you struggled with pornography? ___Yes ___No
In the last year, have you struggled sexually? ___Yes ___No
Have you ever been convicted of a felony? ___ Yes ___No
If yes, explain:
References
Please provide us with the contact information for two references. One MUST be a pastor. Neither can be family members.
Pastoral Reference:
First: Last:
Phone Number:
Email:
Relationship:
Reference #2:
First: Last:
Phone Number:
Email:
Relationship:
Personal Statement:
Limit your response to less than 300 words on an additional sheet of paper. Please type or print neatly in pen.
Write an autobiographical sketch, including a brief description of:
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Your personal experience of salvation and faith in Jesus Christ.
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Your Christian life and experience since salvation.
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Your spiritual gifts and talents given by God.
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Your present and past service and ministry in your local church.
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Statement of why you desire to attend The Agora School.
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Your dream-what you feel God is calling you to do after completion of your education.
I hereby state that all the information that I have provided in this application is true and correct. I also understand that submission of this application in no way guarantees or implies acceptance as a student at The Agora School.
Signature: ______________________________ Date: ____________
A separate application for Valley Forge Christian College will be required before final acceptance. It will be provided for submission after this Agora application is approved. Every Agora student will be officially enrolled at VFCC. All coursework will be accredited through Valley Forge and taught locally by Valley Forge-approved Agora professors.
The Agora School for Global Leadership is the educational arm of The Agora Group, Inc., an international missions 501C3, and does not discriminate on the basis of disability, gender, race, color, national origin, or age in its educational policies or any school-administered program.
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