Thank you for applying for admission to CSSM. RM_StatsCSSM RegistrationIf you have any difficulty completing any part of the application process, contact us at (719)300-6364 and we will be glad to help you. All answers on this application will remain confidential to CSSM.Contact InfoFirst Name *Enter your first nameLast Name *Enter your last nameEmail *Mobile Phone Number *Please enter your mobile numberAddreess Country Afghanistan Aland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas, The Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo, The Democratic Republic Of The Cook Islands Costa Rica Cote D'ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia, The Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and the McDonald Islands Holy See Honduras Hong Kong Hungary Iceland India Indonesia Iraq Iran Ireland Isle Of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Korea, Republic Of Kosovo Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Macedonia, The Former Yugoslav Republic Of Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States Of Moldova, Republic Of Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territories Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Barthelemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and The Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania, United Republic Of Thailand Timor-leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Venezuela Vietnam Virgin Islands, British Virgin Islands, U.S. Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe EducationHave you attended any other ministry schools or programs? Yes No Have you attended any other ministry schools or programs?Please give details (including area of study, years attended & graduation date if applicable) for any schools, ministry schools, or programs you have attended.Please give details (including area of study, years attended & graduation date if applicable) for any schools, ministry schools, or programs you have attended.FamilyCurrent Marital Status Married Single Divorced Widowed Current Marital StatusWhat is your spouse's name?What is your spouse's name?Will your spouse be attending CSSM? Yes No Will your spouse be attending CSSM?Do you have children? Yes No Do you have children?Will any of your children be attending CSSM? Yes No Will any of your children be attending CSSM?Children's names:Children's names:Emergency ContactEmergency contact name and relationship:Emergency contact name and relationship:Phone and mailing address:Phone and mailing address:Revivalist Lifestyle Guidelines"A revivalist is a believer who is focused and passionate, willing to pay any price to live in community, purity and power." We are asking you to "pay the price" of transparency and trust as you answer the following very personal questions. We don’t mean to highlight sin, as we know believers are forgiven and are new creations in Christ, but it is helpful for you to seriously consider our expectations in order to know if you will thrive at CSSM. The freedom of the CSSM environment demands a high level of self-control and it works best when this sort of self-management is already being demonstrated before you come as we are not a recovery or a discipleship school. If you are still trying to figure out your commitment to Christ or to personal holiness and wholeness, we are not the school for you. If this is the case, God has a different assignment for you at this stage of your life. However, having had setbacks or struggles in these areas does not automatically disqualify you from being accepted as a student. If you are in agreement with these guidelines, then continue to fill out the application below. After reviewing your application, we may request a personal interview. Your honest answers to these questions are mutually helpful in deciding if CSSM is a fit for you at this time.Acknowledgement * I have read and agree to follow the Revivalist Lifestyle Guidelines during my time at CSSM. AcknowledgementNOTE: Answering YES to the following question will NOT automatically disqualify the applicant from acceptance.Have you had a problem with alcohol, tobacco, illegal drugs, or pornography within the last 24 months? And/or have you ever been arrested? Yes No Have you had a problem with alcohol, tobacco, illegal drugs, or pornography within the last 24 months? And/or have you ever been arrested?Please explain.Please explain.Spiritual HistoryWhen did you accept Christ as your personal Savior?When did you accept Christ as your personal Savior?Have you been baptized in the Holy Spirit according to Acts 1:8 and Acts 2:4? Yes No Have you been baptized in the Holy Spirit according to Acts 1:8 and Acts 2:4?How do you know you were baptized in the Spirit? Please tell us about this.How do you know you were baptized in the Spirit? Please tell us about this.Are you currently serving in your local church? Yes No Are you currently serving in your local church?If yes, in what capacity? If no, please provide details.If yes, in what capacity? If no, please provide details.Please give a brief description of any Christian service you’ve done (i.e. ministry experience, volunteer work, etc.).Please give a brief description of any Christian service you’ve done (i.e. ministry experience, volunteer work, etc.).Please give a brief description of your Christian journey (i.e. how you came to know the Lord; your present walk with the Lord).Please give a brief description of your Christian journey (i.e. how you came to know the Lord; your present walk with the Lord).CSSM and YouHow did you hear about CSSM?How did you hear about CSSM?Briefly explain why you want to attend CSSM.Briefly explain why you want to attend CSSM.Have you read any books by Bill Johnson or Kris Vallotton? Have you been exposed to any other teaching material (i.e. audio or video teaching, conferences, etc.) from a leader at Bethel Church? Please list them.Have you read any books by Bill Johnson or Kris Vallotton? Have you been exposed to any other teaching material (i.e. audio or video teaching, conferences, etc.) from a leader at Bethel Church? Please list them.Please list any other books or teaching material, (audio or video teaching, conferences, etc.) that have impacted you, i.e. who do you follow?Please list any other books or teaching material, (audio or video teaching, conferences, etc.) that have impacted you, i.e. who do you follow?Username *Password *Password must be at least 7 characters long.Enter password again *Password must be at least 7 characters long. Note: It looks like JavaScript is disabled in your browser. Some elements of this form may require JavaScript to work properly. If you have trouble submitting the form, try enabling JavaScript momentarily and resubmit. JavaScript settings are usually found in Browser Settings or Browser Developer menu.
