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RLA Application

What session are you applying for?*

First Name*

Last Name*

Phone*

Email*

Multi-line address

Country/Region*

Address*

Address - line 2

City*

Zip / Postal code*

Social Media Handles

Date of Birth*

Month

Day

Year

Gender*

Marital Status*

Are you a citizen of the United States?

Yes

No

Have you accepted Jesus Christ as your Lord and Savior?*

Yes

No

Do you attend church regularly?*

Yes

No

How long have you attended your church?

What is your Senior Pastor's name?

How did you hear about Rise Leadership Academy?*

What is your country of origin?*

Please list any languages you speak other than English and whether fluent/conversational

EDUCATION

Select the Highest Level of Education Completed

College Degree

Some College

High School

GED

Some High School

EMPLOYMENT

Are you currently employed?*

Yes

No

LIFESTYLE

Are you able to lift, carry, push or pull up to 35lbs?*

Are you able to navigate stairs (up to three flights)?*

Do you require any special accommodations to support your learning or participation?*

Please share the accommodations you would like to request to support your learning and participation?*

Have you ever used illegal drugs?*

Yes

No

Do you currently smoke? (This includes vaping, any form of nicotine and use of Marijuana)*

Yes

No

Do you currently drink alcoholic beverages?*

Yes

No

Have you ever been arrested?*

Yes

No

COMMITMENT

If you are accepted into Rise Leadership Academy, are you willing to make a 1-2 year commitment?*

Yes

No

Do you understand that being a part of RLA will require you to live at a high biblical standard?*

Yes

No

List some qualities you think are necessary to be a leader?*

Please write a brief personal testimony (200 word minimum)*

REFERENCES

REFERENCE 1

Reference 1 Name (first, last)*

Reference 1 Relation*

Reference 1 Phone Number*

Reference 1 Email*

REFERENCE 2

Reference 2 Name (first, last)*

Reference 2 Relation*

Reference 2 Phone Number*

Reference 2 Email*

REFERENCE 3

Reference 3 Name (first, last)*

Reference 3 Relation*

Reference 3 Phone Number*

Reference 3 Email*

VIDEO UPLOAD (from Youtube or other platform)

RLA Application Testimony Video

We’re excited to learn more about YOU! Please make a 3-minute video sharing your testimony...then send us the Youtube link to the video. In your video, tell us:

Who you are: Share your name and a little about your background.
What God has done in your life: Describe how God has impacted your journey and shaped who you are today.
Why you want to join Rise Leadership Academy: Explain what draws you to this program and how you believe it will help you fulfill God’s purpose for your life.

VIDEO UPLOAD (without Youtube)

VIDEO UPLOAD (send your video directly to us...without Youtube or other video platform)

ATTENTION: Make sure you've answered the entire application AND uploaded your video BEFORE you click the SUBMIT button below. Thanks!

Rise Leadership Academy is a faith-based college dedicated to helping individuals discover their God-given purpose and equipping them to reach the lost, make disciples, and lead the world with a Christ-centered vision.

Get in touch with us.

First Name

Email

Last Name

Phone

Thanks for submitting!

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