Basic information Full Name * Date of birth * MM DD YYYY Gender * Male Female Prefer not to say Contact Address * Post code * Your email address * Your phone number * Medical information Do you have any major health issues of which we may need to be aware? Do you have any dietary requirements? Emergency contact name * Emergency contact number * Emergency contact relationship to you * More about you Do you attend Freedom Church Liverpool? * Yes No If you do not attend Freedom Church, please tell us the church that you currently attend If you do not attend Freedom Church, please tell us the name and contact details of a senior leader in your church I have received endorsement from a member of leadership in my church to apply for Academy * Yes Please describe any roles or areas in which you serve at your church * Why do you want to join the New Ground Academy? * Have you undertaken any previous Christian training or theological studies? Are there any circumstances which would affect your ability to prepare and attend each month? * Fees It is our heart that no one be excluded from attending Academy due to financial reasons. If you would like to attend Academy but are unable to afford the full cost, please tick the box below to indicate that assistance is required and someone will be in touch. Financial assistance required Please select the relevant fee that you will be paying for Academy * Fees for Academy 2021/2022 are £200 per year for an individual or £320 per year for a married couple attending together. Please indicate below which fee applies to you. Individual - £200 Married couple - £320 If attending as part of a married couple please provide the name of your spouse If paying upfront, payment will be required before the first Academy session September 2021. If paying in installments, payments will be taken in September 2021 and February 2022 * Please indicate below which payment plan you wish to use Option 1 - Upfront Option 2 - Installments I confirm to the best of my knowledge that all the information I have provided is correct * I confirm Test
