Application

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Application

To get the process started, just fill out the simple application below.
If you prefer to fill things out by hand, you can print the application
by clicking this link... - GZMC Student Application

Your Information

Email Address

First Name

Middle Name

Last Name

Preferred Name

Home Phone Number

(Include Area Code.)

Cell Phone Number

(Include Area Code.)

Present Mailing Address

City, State & Zip

Birthdate (mm/dd/yyyy)

Current Age

Height

Weight lbs.

Gender

T-Shirt Size

(adult sizes)

Marital Status

How did you hear about Ground Zero Master's Commission?

Family Information

Biological Father		Biological Mother
	Name
	Address
	City, State & Zip
	Phone Number
	Occupation
	Accepted Christ?
	Marital Status?
	My Siblings include
If parents were separated or divorced, how old were you at the time?
If Father and/or Mother is deceased, how old were you at the time?
Who did you live with and how long?
If Parents are remarried, describe your relationship with yout step-parent(s)/sibling(s):

Check the statements that describe your family history:

Excellent Christian Home
Parental Job Instability
Warm Relationship With Parents
Relatives Lived Nearby
Warm Relationship With Siblings
Close With Extended Family
Sibling Rivalry
Physical Abuse As A Child
Father/Mother Absent
Mental/Emotional Abuse

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125 Saginaw Rd • New London TWP, PA 19352
Phone: 610.869.7332 • Email Us