Summer

2010

SEYC Summer of Evangelism

Student Application
Thank you for your interest in the SEYC Summer of Evangelism program. Please fill out this application and
return, along with your $25 application fee and a current picture of yourself, to the address provided at the
bottom of this page by April 15, 2010. Please notify your references of the application deadline, as applications
will not be reviewed until all components are completed and submitted.

Application Checklist:
 Application for Admission  Current Photo of yourself
 Application Fee – $25  Three References

“And Jesus came and spake unto them, saying, All power is given unto me in heaven and in earth. Go ye therefore, and teach
all nations, baptizing them in the name of the Father, and of the Son, and of the Holy Ghost: teaching them to observe all
things whatsoever I have commanded you: and, lo, I am with you always, even unto the end of the world. Amen.”
– Matthew 28:18-20

SEYC Summer of Evangelism

P.O. Box 35, Collegedale, TN 37315
Phone: 423-615-9537 Fax: 423-236-1976 Email: info@seyc.org
 Application for
Admission

Personal Information

Name: ______________________________________________________________________________________________________
first middle last
Mailing
Address: ____________________________________________________________________________________________________
street

____________________________________________________________________________________________________________ 
city state zip/postal code country

Phone (include area code): ______________________________________________________________________________________

home cell

Email: ______________________________________________________________________________________________________

Gender:  Male  Female Date of Birth: __________/_________/__________ Age: __________

month day year

Is English your first language:  Yes  No

Please list any languages in addition to English that you speak fluently: __________________________________________________

Are you a student of Southern Adventist University? Yes No

Family Information

Marital Status:  Single  Married  Separated  Divorced  Widowed

Spouse’s Name: __________________________________ Spouse’s Date of Birth: __________/_________/__________

month day year

Do you have children?  Yes  No If so, how many? _______ What are their ages? __________________

Education and Work History

Please list your current occupation: ______________________________________________________________________________

  1 
Please list your previous employment:
Company Dates of Employment Position/Responsibilities

Please list your previous education/training:

Name of School Year Program Type Degree/Certificate

Have you ever been dismissed from any educational institution?  Yes  No (If so, please attach an explanation)

Spiritual Information

Church Affiliation: _____________________________________________ Are you a baptized member?  Yes  No

Baptismal Date: __________/_________/__________

month day year

Local Church Membership: __________________________________ Church Phone Number: _________________________

Name of Pastor: ____________________________________________ Pastor’s Phone Number: __________________________

Define/describe your present spiritual condition: ____________________________________________________________________

____________________________________________________________________________________________________________ 

____________________________________________________________________________________________________________ 

____________________________________________________________________________________________________________ 

How would you describe your knowledge of the Bible? ______________________________________________________________

____________________________________________________________________________________________________________ 

____________________________________________________________________________________________________________ 

What is your main objective in attending SEYC Summer of Evangelism? ________________________________________________

____________________________________________________________________________________________________________ 

____________________________________________________________________________________________________________ 

  2 
Rate your understanding of the fundamental beliefs and practices of the Seventh-day Adventist Church:  1  2  3  4  5
(1= no understanding, 2= low understanding, 3= general understanding, 4= high understanding, 5= complete understanding)

Are you in agreement with them?  Yes  No (If not, please attach an explanation)

Have you ever done door-to-door ministry?  Yes  No Have you had any special training in soul winning?  Yes  No

Please describe any previous training and/or experience in soul winning? _________________________________________________

____________________________________________________________________________________________________________ 

____________________________________________________________________________________________________________ 

____________________________________________________________________________________________________________ 

Other Information

How did you hear about SEYC Summer of Evangelism? _____________________________________________________________

____________________________________________________________________________________________________________ 

List your hobbies and/or leisure activities: _________________________________________________________________________

____________________________________________________________________________________________________________ 

Please list favorite authors or public speakers and why you particularly like them: _________________________________________

____________________________________________________________________________________________________________

____________________________________________________________________________________________________________ 

Are you bringing a vehicle with you?  Yes  No Are you willing to have others carpool with you for outreach?  Yes  No

Will you need to be picked up from the airport at the beginning of the program?  Yes  No

Will you need to be dropped off at the airport at the end of the program?  Yes  No

Have you ever been convicted of a crime other than a traffic violation?  Yes  No (If so, please attach an explanation)

References

Please provide three references (non-family members):

Reference Name Phone Number Relation to You How Long Acquainted

  3 
Academic Credit Options

The School of Religion at Southern Adventist University is providing up to six semester hours of academic credit for those who
want/need it. Please select the type and amount of credit you are interested in from the options below. NOTE: If you are not a
currently enrolled student of Southern Adventist University and you are seeking academic credit, then an application for Southern
must be filled out and submitted in addition to this application. Applications can be acquired from Southern’s Admissions Office or
from the website, www.southern.edu.

If you would like to attend SEYC Summer of Evangelism program without academic credit, please check:  No Credit

If you would like to receive Practicum credit, please check one of the following:
 1 Credit (RELP 291 – Practicum)  2 Credits (RELP 291 – Practicum)  3 Credits (RELP 291 – Practicum)
 1 Credit (RELP 391 – Practicum)  2 Credits (RELP 391 – Practicum)  3 Credits (RELP 391 – Practicum)

If you would like to receive Christian Witnessing Credit, please check:  3 Credits (RELP 264 – Christian Witnessing)

Costs

Non-Student/No Credit: $700 (Program Fee; includes lodging and 2 meals per day)
Non-Student/No Credit/Local Commuter: $250 (Program Fee; no lodging, no meals)
Student/Credit: $700 (Lab Fee 18) + $529 per credit hour*

*Note: Academic Credit is offered through the School of Religion at Southern Adventist University. Upon acceptance, more
information will be given regarding student registration through Southern.

Applicant’s Initials & Signature

Please read and initial the following:

___ I understand that full payment for this summer program or lab fee is due on or before Registration.

___ I certify that all of the information that I have supplied on this application is true and correct. I realize that falsification of any
information I provide to SEYC Summer of Evangelism is grounds for immediate dismissal, without refund.

___ My application fee for $25 is enclosed with this application.

____________________________________________________________________________________________________________
Signature Date Print Name

  4 
 Reference
Form

Applicant Information

Applicant’s Name: ___________________________________________________________________________________________

The person named above desires to be a student for the SEYC Summer of Evangelism program and has given your name as a
reference. The program accepts individuals who have a commitment to Christian service and who will support the principles and
practices of the program. This referral will be kept strictly confidential. Thank you for your time in providing us with your honest
appraisal of this applicant. We may also be contacting you by phone.

Reference Questions

How long have you known the applicant? _________ (years)

What is your relationship to the applicant?  Teacher  Pastor  Employer  Acquaintance  Other: ___________________

What are the applicant’s strengths? ______________________________________________________________________________

___________________________________________________________________________________________________________

In what ways might the applicant need to experience positive growth? __________________________________________________

___________________________________________________________________________________________________________

Do you have any information about the applicant’s life or background that you believe might be of particular concern to SEYC
Summer of Evangelism program? Yes No If so, please explain: _____________________________________________

____________________________________________________________________________________________________________

How will the applicant adjust to living with others for 5 weeks? ________________________________________________________

____________________________________________________________________________________________________________

Additional comments (optional): ________________________________________________________________________________

____________________________________________________________________________________________________________

____________________________________________________________________________________________________________

____________________________________________________________________________________________________________

____________________________________________________________________________________________________________
Appraisal of Applicant

Please mark the boxes below, which best describe the applicant for each category of evaluation. (Note: 1 indicates the applicant is
most like the characteristics on the left side, and 5 the characteristics on the right side. Numbers 2, 3, and 4 show moderate
association with either side.) If you feel that you don’t know the applicant well enough for a fair evaluation on any specific item, you
may mark the box at the far right, “Insufficient Information.”
Insufficient
Information
Category Negative Characteristic 1 2 3 4 5 Positive Characteristic

Spirituality Immature, shaky, stagnating      Strong, stable, growing 

Intellect Slow, unmotivated, self-satisfied      Vigorous, creative, learning 

Judgment Rash, impulsive, headstrong      Sound, careful, teachable 

Indifferent, self-centered, needs Compassionate, unselfish, takes

Service Attitude      
directing initiative

Attitude Toward Noncompliant, disrespectful, Compliant, respectful, follows

     
Authority independent directions

Lazy, incomplete, needs constant Diligent, thorough, follows through,

Industriousness      
supervision, unmotivated self motivated

Relationship to
Critical, divisive, distant      Deeply committed, loyal, supportive 
his/her Church

Healthful Lifestyle Uninformed, careless, seems sickly      Informed, conscientious, seems healthy 

Shy, introverted, unsocial, works Secure, outgoing, friendly, works well

Sociability      
poorly with others with others

Considering the applicant for acceptance as a student for the SEYC Summer of Evangelism program:
 I recommend without reservation  I do not recommend under the present circumstances
 I recommend with some reservation  I do not recommend under any circumstances

Reference Information

Your Name: _____________________________________________ Position/Title: ___________________________________

Address: ________________________________________________ Phone number: __________________________________

________________________________________________

________________________________________________

____________________________________________________________________________________________________________
Signature Date Print Name

Please return this form to the South East Youth Conference.

P.O. Box 35 Collegedale, TN 37315 Fax: 423-236-1976 Email: info@seyc.org
 Reference
Form

Applicant Information

Applicant’s Name: ___________________________________________________________________________________________

The person named above desires to be a student for the SEYC Summer of Evangelism program and has given your name as a
reference. The program accepts individuals who have a commitment to Christian service and who will support the principles and
practices of the program. This referral will be kept strictly confidential. Thank you for your time in providing us with your honest
appraisal of this applicant. We may also be contacting you by phone.

Reference Questions

How long have you known the applicant? _________ (years)

What is your relationship to the applicant?  Teacher  Pastor  Employer  Acquaintance  Other: ___________________

What are the applicant’s strengths? ______________________________________________________________________________

___________________________________________________________________________________________________________

In what ways might the applicant need to experience positive growth? __________________________________________________

___________________________________________________________________________________________________________

Do you have any information about the applicant’s life or background that you believe might be of particular concern to SEYC
Summer of Evangelism program? Yes No If so, please explain: _____________________________________________

____________________________________________________________________________________________________________

How will the applicant adjust to living with others for 5 weeks? ________________________________________________________

____________________________________________________________________________________________________________

Additional comments (optional): ________________________________________________________________________________

____________________________________________________________________________________________________________

____________________________________________________________________________________________________________

____________________________________________________________________________________________________________

____________________________________________________________________________________________________________
Appraisal of Applicant

Please mark the boxes below, which best describe the applicant for each category of evaluation. (Note: 1 indicates the applicant is
most like the characteristics on the left side, and 5 the characteristics on the right side. Numbers 2, 3, and 4 show moderate
association with either side.) If you feel that you don’t know the applicant well enough for a fair evaluation on any specific item, you
may mark the box at the far right, “Insufficient Information.”
Insufficient
Information
Category Negative Characteristic 1 2 3 4 5 Positive Characteristic

Spirituality Immature, shaky, stagnating      Strong, stable, growing 

Intellect Slow, unmotivated, self-satisfied      Vigorous, creative, learning 

Judgment Rash, impulsive, headstrong      Sound, careful, teachable 

Indifferent, self-centered, needs Compassionate, unselfish, takes

Service Attitude      
directing initiative

Attitude Toward Noncompliant, disrespectful, Compliant, respectful, follows

     
Authority independent directions

Lazy, incomplete, needs constant Diligent, thorough, follows through,

Industriousness      
supervision, unmotivated self motivated

Relationship to
Critical, divisive, distant      Deeply committed, loyal, supportive 
his/her Church

Healthful Lifestyle Uninformed, careless, seems sickly      Informed, conscientious, seems healthy 

Shy, introverted, unsocial, works Secure, outgoing, friendly, works well

Sociability      
poorly with others with others

Considering the applicant for acceptance as a student for the SEYC Summer of Evangelism program:
 I recommend without reservation  I do not recommend under the present circumstances
 I recommend with some reservation  I do not recommend under any circumstances

Reference Information

Your Name: _____________________________________________ Position/Title: ___________________________________

Address: ________________________________________________ Phone number: __________________________________

________________________________________________

________________________________________________

____________________________________________________________________________________________________________
Signature Date Print Name

Please return this form to the South East Youth Conference.

P.O. Box 35 Collegedale, TN 37315 Fax: 423-236-1976 Email: info@seyc.org
 Reference
Form

Applicant Information

Applicant’s Name: ___________________________________________________________________________________________

The person named above desires to be a student for the SEYC Summer of Evangelism program and has given your name as a
reference. The program accepts individuals who have a commitment to Christian service and who will support the principles and
practices of the program. This referral will be kept strictly confidential. Thank you for your time in providing us with your honest
appraisal of this applicant. We may also be contacting you by phone.

Reference Questions

How long have you known the applicant? _________ (years)

What is your relationship to the applicant?  Teacher  Pastor  Employer  Acquaintance  Other: ___________________

What are the applicant’s strengths? ______________________________________________________________________________

___________________________________________________________________________________________________________

In what ways might the applicant need to experience positive growth? __________________________________________________

___________________________________________________________________________________________________________

Do you have any information about the applicant’s life or background that you believe might be of particular concern to SEYC
Summer of Evangelism program? Yes No If so, please explain: _____________________________________________

____________________________________________________________________________________________________________

How will the applicant adjust to living with others for 5 weeks? ________________________________________________________

____________________________________________________________________________________________________________

Additional comments (optional): ________________________________________________________________________________

____________________________________________________________________________________________________________

____________________________________________________________________________________________________________

____________________________________________________________________________________________________________

____________________________________________________________________________________________________________
Appraisal of Applicant

Please mark the boxes below, which best describe the applicant for each category of evaluation. (Note: 1 indicates the applicant is
most like the characteristics on the left side, and 5 the characteristics on the right side. Numbers 2, 3, and 4 show moderate
association with either side.) If you feel that you don’t know the applicant well enough for a fair evaluation on any specific item, you
may mark the box at the far right, “Insufficient Information.”
Insufficient
Information
Category Negative Characteristic 1 2 3 4 5 Positive Characteristic

Spirituality Immature, shaky, stagnating      Strong, stable, growing 

Intellect Slow, unmotivated, self-satisfied      Vigorous, creative, learning 

Judgment Rash, impulsive, headstrong      Sound, careful, teachable 

Indifferent, self-centered, needs Compassionate, unselfish, takes

Service Attitude      
directing initiative

Attitude Toward Noncompliant, disrespectful, Compliant, respectful, follows

     
Authority independent directions

Lazy, incomplete, needs constant Diligent, thorough, follows through,

Industriousness      
supervision, unmotivated self motivated

Relationship to
Critical, divisive, distant      Deeply committed, loyal, supportive 
his/her Church

Healthful Lifestyle Uninformed, careless, seems sickly      Informed, conscientious, seems healthy 

Shy, introverted, unsocial, works Secure, outgoing, friendly, works well

Sociability      
poorly with others with others

Considering the applicant for acceptance as a student for the SEYC Summer of Evangelism program:
 I recommend without reservation  I do not recommend under the present circumstances
 I recommend with some reservation  I do not recommend under any circumstances

Reference Information

Your Name: _____________________________________________ Position/Title: ___________________________________

Address: ________________________________________________ Phone number: __________________________________

________________________________________________

________________________________________________

____________________________________________________________________________________________________________
Signature Date Print Name

Please return this form to the South East Youth Conference.

P.O. Box 35 Collegedale, TN 37315 Fax: 423-236-1976 Email: info@seyc.org