Leadership Missions Application

We are so excited that you are desiring to join us for our Leadership Missions Training! If at any time during this application process you have questions or are unsure about something, feel free to check out our Leadership Missions Training FAQs Page. If you have any additional questions, please contact us. Thanks so much for applying!

Leadership Missions Application

1General Information

2References

3Guidelines and Personal Assessment

4Character Asessment

5Medical Release

6Background Check

7Policies

General Information

You'll need:
-Social Security Number
-Driver's License (if you have one)
-Digital Photo
-A parent's signature if you are under 18
Hidden
Untitled
- First Choice
- Second Choice
- Third Choice
Email*
Full Legal Name*
First Middle Last
Gender*
- Female
- Male

Phone Numbers*

Home phone	Cell phone (cell phones are required)

Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Birthdate*
MM slash DD slash YYYY

Hidden

Birth date (Hidden)

Birth date (mm/dd/yyyy)	Age

Recent Photo*
Accepted file types: jpg, gif, png, pdf, tif, rif, Max. file size: 128 MB.
What's the best way to reach you?*
- Email
- Home phone
- Cell phone
- Other
Program Rates and Discounts
Coming for a full year?*
If yes, then select the first session you'll be attending.
- Yes
- No
Choose the session you would like to attend:*
Note: The ITG graduation will occur during the last Saturday of the session. Attendees will fly or drive out on Sunday, the next day.
- Fall 2022: August 28 - Nov. 19
- Winter 2023: Jan. 8 - March 11
- Spring 2023: March 26 - May 20
Fall: choose applicable rate
- Early Rate: $2200 (Ends July 31st)
- Regular: $2600 (Ends August 12)
Winter: choose applicable rate
- Early Bird: $2200 (Ends Dec. 9)
- Regular: $2600 (Ends Dec. 27)
Spring: choose applicable rate
- Early Bird: $2200 (Ends Feb. 24)
- Regular: $2600 (Ends March 11)
Which level are you applying to attend?*
- Level 1
- Level 2
- Level 3
- Level 4
- Level 5
- Level Advancement Opportunity
Level 2 Partial Scholarship
Congrats! Because you're coming back for Level 2, we're pleased to award you a $200 scholarship off your tuition! Yep, you're welcome.
Price:
Level 3 Partial Scholarship
Congrats! Because you're coming back for Level 3, we're pleased to award you a $300 scholarship off your tuition! Yep, you're welcome.
Price:
Level 4 Partial Scholarship
Congrats! Because you're coming back for Level 4, we're pleased to award you a $400 scholarship off your tuition! Yep, you're welcome.
Price:
Which session did you last attend?*
Are you returning for a consecutive level?
(Simply put, are you coming back without having skipped any sessions?)
- Yes
- No
Consecutive discount
Great! There's a new consecutive discount available for you! It'll be applied to your total.
Price:
$20 Deposit
There will be a $20 deposit for your dorm room.
- Please bring Cash for your deposit to registration.
- Please do not send the deposit in beforehand.

Note: Your deposit will be returned to you as you leave at the end of session, given that your room passes the cleaning checklist and final inspection.
$25 Room Deposit (Hidden)
There will be a $25 deposit for your dorm room.
- Check or credit cards are acceptable.
- Cash is preferred.

Note: Deposit is due 30 days before session start date, unless you have the exact amount in cash. If using cash, you may deliver it when you register on the first day of session.

Your deposit will be returned to you as you leave at the end of session, given that your room passes the cleaning checklist and final inspection.
Price:
Tuition Payment
How you intend to pay your tuition:*
There's a $25 non-refundable application fee.
- Early Pay - Remaining balance due 60 days before session start date.
- Regular Pay - Remaining balance due 30 days before session start date.
- Payment Plan
  - 50% of remaining balance paid 30 days before start date
  - - Remaining balance (+ $50 payment plan fee) due 30 days after session start date
  - For more information, please contact us via [email protected].
    Please be sure you understand how it works before selecting this option.
Coupon code (if applicable)
Total
$0.00

Release of Liability and Medical Consent
Please read release carefully. All typed signatures are legally binding.
Full name (first, middle, last).*
I, the below stated, in consideration for the training and the experience which I will receive through volunteer service projects with In The Gap, do hereby release In The Gap, as well as its employees, agents, and voluntary helpers (releasees) from any and all liability arising from any and all injuries to myself, or property damage to my belongings, which may occur while I participate in service with In The Gap. I recognize the potential for physical injury to which I may be exposed in the course of my training and service, but I knowingly and freely assume all such risks, even if arising from the negligence of the releasees or others, and I assume full responsibility for my participation. In consideration of the aforementioned benefits, I voluntarily authorize In The Gap, and any of its employees, agents, or other volunteer supervisors responsible for my well-being, to personally provide or to make reasonable arrangements for any emergency medical care which should become necessary while I am participating/working with In The Gap. I understand that, should emergency care be necessary, my emergency contacts (as referenced below) will be contacted as soon as is reasonably possible. I further state that I have carefully read the liability and medical release below, that I understand it's content, and that I willingly agree to the contents thereof. I fully understand the arrangements made for my personal care, and willingly consent to In The Gap's provision for my spiritual, emotional, mental, and physical welfare during the period of time I am under the authority of In The Gap. I voluntarily, and of my own free will, sign this release of liability and medical consent form.
First Middle Last
Student signature*
By typing your name here, you are signifying that you have read, understand, and agree to the above release. This is your legal signature.
Today's date*
Parent signature (if student is under 18)
By typing your name here, you are signifying that you have read, understand and agree to the above release. This is your legal signature.
Today's date
Parent's phone

Additional contact in case of emergency*

Please indicate name, relationship, and phone number.

Name	Relationship	Phone number

Insurance company (if applicable)
Insurance Policy Number (if applicable)
Date of birth*
Blood type (if known)*
Are you allergic to any medications? If yes, please indicate which types.*
Please use a "," between the items.
Hidden
Are you allergic to any medications? If yes, please indicate which types. (Hidden)
Are you currently using any form of medication (including over the counter medication)? If so, what types?
Please use a "," between the items.
Hidden
Are you currently using any form of medication (including over the counter medication)? If so, what types? (Hidden)
Do you have any known food allergies? If so, please indicate what types.
Please use a "," between the items and indicate the severity of each allergy.
Hidden
Do you have any known food allergies? If so, please indicate what types. (Hidden)

Background Check Information
Please read authorization carefully. All typed signatures are legally binding.
Full name*
In connection with my future involvement as a staff member or a volunteer working with youth or children, I, the below stated, understand that In The Gap and/or its agents, may conduct a background check and obtain all records whether they are of a public, private, or confidential nature to determine my ability to minister in this role. It may include information concerning my character, work habits, performance, and any court records that may have a bearing on my job responsibilities. I acknowledge that a telephonic facsimile (fax) or photographic copy shall be as valid as the original. I hereby authorize, without reservation, any law enforcement agency, institution, information service bureau, schooling agency or its agent, to furnish the information described above. In addition, I release and discharge In The Gap and its agents and associates to the full extent permitted by law from any claims, damages, losses, liabilities, costs, expenses, or any other chard or complaint filed with any agency arising from retrieving and reporting this information. I understand that if any of those records contain information that is used to deny my services at In The Gap, I will be notified of my rights and where I can obtain a copy of the information. I understand that a complete listing of my rights under the Fair Credit Reporting Act can be obtained at www.ftc.gov/credit.
First Middle Last
Student signature*
By typing your name here, you are signifying that you have read, understand, and agree to the above authorization. This is your legal signature.
Date*
Social Security Number*
Birth date*
Name
First Last
Gender*
- Male
- Female
Race*
- African American
- Caucasian
- Asian
- Hispanic
Do you have a current driver's license?*
- Yes
- No
What is your license number and state?
Other or former names
Current address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
All other resident home addresses for the past 5 years
Parent signature (if student is under 18)
By typing your name here, you are signifying that you have read, understand, and agree to the above authorization. This is your legal signature.
Today's date*
Policy Agreements
In preparation for this section, please read the Child Protection Policies and Statement of Faith, and the In The Gap Guidelines found below.
ITGLeadershipMissionsTraining-CPP
ITGLeadershipMissionsTraining-SoF
Leadership Missions Training Guy/Girl Dress Code
Student Signature*
By typing your name here, you are signifying that you have read the above stated Child Protection Policies and Statement of Faith and the In The Gap Resident Guidelines, and that you understand and are willing to wholeheartedly abide by their contents. Also by typing your name above, you are indicating that you recognize this is a legally binding agreement, that all answers you have given are true and complete to the best of your knowledge, and that you are giving In The Gap the right to use your pictures, voice and testimony for promotional materials. This is your legal signature.
Today's date*
Parent signature*
By typing your name here, you are indicating that you have reviewed and agree with the In The Gap guidelines, have discussed them with your son/daughter, and will encourage him/her to abide by these guidelines. You are also giving In The Gap the right to use your student's pictures, voice and testimony for promotional materials. This is your legal signature.
Today's date*

Leadership Missions Application

Leadership Missions Application

General Information

You'll need:

Program Rates and Discounts

Tuition Payment

Church Information

Parent Information

References

Additional information

Personal Questionnaire

Personal Character Assessment

From the above assessment, what are the top three areas of needed growth along with an action step that would help you grow in that area?

Release of Liability and Medical Consent

Background Check Information

Policy Agreements

8. Payment

Spiritual gift: exhorter, giver, mercy, organizer, prophet, servant, teacher.	Love Language: acts of service, gifts, physical touch, quality time, words of affirmation.

Number of Siblings	Birth order

Phone	Website