The Necessary Training Program Application - Abiding Truth Ministries, CDC

First Name *

Middle Name/Initial

Last Name *

Gender *

Male
Female

Address *

City *

State *

Zip Code *

Email *

Contact Phone # *

Date of Birth *

School

If a minor child, name and address of school student currently attending.

Last Grade Completed *

Student has an IEP

Yes
No

Covid Vaccinated? *

Yes
No

Boosted? *

Yes
No

List any medicines, medical issues, or problems we should know about.

Race *

Religion *

Checking Account *

Yes
No

Do you have Cash App/Venmo/Paypal or other way to receive payments? *

Yes
No

Indicate your primary payment service and handle/email.

i.e., Cash App-$yourname

How did you hear about us? *

Emergency Contact/Guardian Full Name *

Relationship to Student *

Emergency Contact/Guardian Phone # *

Email

Address

City

State

Zip Code

2nd Contact/Guardian Full Name

Relationship to Student

2nd Contact/Guardian Phone Number

Email

2nd Contact/Guardian Address

City

State

Zip Code

Skills/Hobbies *

Checkboxes (Choose only one area of interest.) *

Carpentry / Electricity / Plumbing
Sewing
Content Creation (Audio/Video, Green Screen)

Other