Name *
Phone *
Date of Birth *
Date of Birth
How Did You Hear About This Opportunity? *
Parent Name *
Parent Name
Parent Phone *
Parent Phone
Referral 1 *
Referral 1
Must not be related.
Referral 1 Phone *
Referral 1 Phone
Referral 2 *
Referral 2
Referral 2 Phone *
Referral 2 Phone
Referral 3 *
Referral 3
Must be someone who knows about you as a student
Referral 3 Phone *
Referral 3 Phone
By completing this form and typing your name below, you authorize Seeds of Grace to contact your references to determine your candidacy for this program. You also confirm that everything in this form is true. You also confirm that you will be in attendance on May 2, 2016 6:00 PM at the Seeds of Grace HQ, located at 616 Pacific Avenue in Bremerton. You also confirm that you have your parent's permission to participate, if chosen for the team.
Today's Date *
Today's Date

Thank you for taking the time to apply for this program.  Your application will be carefully considered, your references will be called, and after the group interview on May 2, 2016 you will be notified about your status on the team.