Dear Applicant

Thank you for your interest in Jacksonville Master's Commission.  God is not only calling Master's Commission students, but He is calling everyone to a more intimate relationship with Him.  If that is a call you hear and want to relentlessly respond to, JMC is where you should be!  The following application will help us to know facts about you, your history, and most importantly your heart.  We are not looking for perfection.  What we really want to know is just two things:

First we want to know if you are willing to do whatever it takes to develop the character of a disciple of Jesus Christ.  Secondly we want to follow the leading of the Holy Spirit to know if Jacksonville Master's Commission is the place that God has called you to be discipled.

I am thankful for your interest in JMC.  I trust that whether or not you join us in Jacksonville you will pursue Jesus with a greater passion each new day!  If there is any way we can be of assistance to you, please contact us at (904)-751-0552.  We will do all that we can to help.

Sincerely,

Director - Jacksonville Master's Commission



Application for JMC

Personal Information
Full Name:
Nick Name:
(Name you Go by)
E-mail:
My Space Address:
Street Address:
City:
State:
Postal Code:
Phone:
Birth Date:
Sex:
Age:
Social Security Number:
Marital Status:
If married, how long?
If Divorced, when?
   

PAST / PRESENT

 Please select past or present to all that apply.
Abortion: Never  Past  Present
Abortion Guilt:
(guy or girl)		 Never  Past  Present
Abused as a child: Never  Past  Present
Anger/temper: Never  Past  Present
Anxiety: Never  Past  Present
Bad driving record: Never  Past  Present
Bitterness: Never  Past  Present
Compulsive gambling: Never  Past  Present
Depression: Never  Past  Present
Doubts about Salvation: Never  Past  Present
Eating Disorder: Never  Past  Present
Extreme body piercing/cutting: Never  Past  Present
Family problems: Never  Past  Present
Fighting: Never  Past  Present
Homosexual or lesbian lifestyle: Never  Past  Present
Insomnia: Never  Past  Present
Inability to concentrate: Never  Past  Present
Lying problems: Never  Past  Present
Learning disabilities: Never  Past  Present
Night terrors:
(dreams)		 Never  Past  Present
Nervous disorders: Never  Past  Present
Pornography: Never  Past  Present
Problems with social relationships: Never  Past  Present
Problems with parents: Never  Past  Present
Reading comprehension: Never  Past  Present
Sadness: Never  Past  Present
Stress: Never  Past  Present
Sexual fantasies and pressures: Never  Past  Present
Sexual promiscuous lifestyle: Never  Past  Present
Suicide attempts: Never  Past  Present
Theft, shoplifting, stealing: Never  Past  Present
Thoughts of suicide: Never  Past  Present
Trouble making decisions: Never  Past  Present
Use of alcohol, drugs, tobacco, etc: Never  Past  Present
Unstable job record: Never  Past  Present
Witchcraft/occult: Never  Past  Present
   
Please explain or make comments on all that were selected above:
   
Family History
Name of Father or Guardian:
Street Address:
City:
State:
Postal Code:
Phone:
Occupation
Accepted Christ?
   
Name of Mother or Guardian:
Street Address:
City:
State:
Postal Code:
Phone:
Occupation
Accepted Christ?
   
Natural Parents:
If married, how many years?
Rate your parent's marriage:
List your brothers and sisters (including step-brothers and step-sisters) from oldest to youngest, including yourself.
Example: John 31 M, Linda 29 F, Me 25, Lisa 19 F (step)
   
Check the statements that describe your family history:
Excellent Christian home Parental job instability
Warm relationship with parents Relatives lived nearby
Warm relationship with brothers/sisters Close relationship with extended family
Sibling rivalry Physical abuse as a child
Father/Mother absent Mental/Emotional abuse as a child
Moved frequently    
   
If parents were separated or divorced, how old were you at the time?
Who did you live with?
How long did you live with them?
Father remarried?
Mother remarried?
If father deceased, how old were you at the time?
If mother deceased, how old were you at the time?
If you had stepparents, how did they relate to you? (kindly, poorly, affectionately, little discipline, etc.)
Stepfather's Name:
Stepfather's Occupation:
Stepmother's Name:
Stepmother's Occupation:
How many times was your father married?
How many times was your mother married?
   
Medical History
How would you describe your health?
List any allergies:
List any physical limitations:
List any medication you are currently using:
Have you ever used illegal drugs?
If yes, date of last use:
Do you currently smoke?
If yes, date of last use:
Do you drink alcoholic beverages?
If yes, date of last use:
   
Employment
Are you currently employed?
Present Employer:
Position:
Date Hired:
Past Employer:
Position:
Date Hired:
Reason for leaving:
Date Left:
   
Financial Background
How do you plan to pay for your tuition?
Will you have the total amount by the required date?
If no, please explain:
Do you own your own vehicle?
(required upon entrance)
Do you have health insurance?
(required upon entrance)
List any debts, loans, payments, that you presently have any amount due for each:
Will your debts be paid off by the start of Master's Commission?
If no, how will you make your payments?
   
Church Background
Name of home church:
Denomination:
Street Address:
City:
State:
Postal Code:
Phone:
Name of Senior Pastor:
Name of Youth Pastor:
How long have you attended this church?
Are you a member of this church?
List the different ministries your are presently involved in: