Thank you for applying for admission to CSSM. CSSM Summer 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 Info First NameEnter your first name Last NameEnter your last name Email Mobile Phone NumberPlease enter your mobile number Addreess Address Line 1 Address Line 2 CityState or Region--Select Country--AfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamas, TheBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo, The Democratic Republic Of TheCook IslandsCosta RicaCote D'ivoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambia, TheGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and the McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle Of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Republic OfKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMacedonia, The Former Yugoslav Republic OfMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia, Federated States OfMoldova, Republic OfMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinian TerritoriesPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussian FederationRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and The GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzania, United Republic OfThailandTimor-lesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country ZipEducation Have you attended any other ministry schools or programs?YesNoHave 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.Family Current Marital StatusMarriedSingleDivorcedWidowedCurrent Marital Status What is your spouse's name?What is your spouse's name? Will your spouse be attending CSSM?YesNoWill your spouse be attending CSSM? Do you have children?YesNoDo you have children? Will any of your children be attending CSSM?YesNoWill any of your children be attending CSSM? Children's names:Children's names:Emergency Contact Emergency 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. AcknowledgementI 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?YesNoHave 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 History When 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?YesNoHave 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?YesNoAre 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 You How 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*