Lead application
Administration
Pierson Institute
Evangelistic Resource Center
LEAD Program
LEAD Application
If you see this don't fill out this input box.
APPLICANT INFORMATION
Last Name:
*
First Name:
Date of Birth:
What is your home address? (Not SAU)
Home Address: City
Home Address: State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Home Address: Zip
What is your cell phone number:
Are you a current Southern student?
What is your Southern email address?
*
Student ID:
Major:
Are you a citizen of the United States?
*
Yes
No
If no, are you authorized to work in the U.S.?
*
Yes
No
Do you have any canvassing experience?
*
Yes
No
If so, where and when?
Have you ever been convicted of a felony?
*
Yes
No
If yes, explain
REFERENCE
Reference: Full Name
Reference: Relationship
Reference: Company
Reference: Phone
Job Title:
Have you had any other door-to-door experience?
*
Yes
No
If so, please describe.
Do you have any other jobs (on or off campus)?
*
No, none.
Yes, one.
Yes, two.
Yes, more than two.
Select Shifts You Are Interested In
*
Sunday 2pm-6pm
Monday 3:30pm-7:30pm
Tuesday 3:30pm-7:30pm
Wednesday 3:30pm-7:30pm
Thursday 3:30pm-7:30pm
Thanksgiving Break
Winter Break
Spring Break
DISCLAIMER AND SIGNATURE
I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.
Signature:
*
Date:
How did you find out about LEAD?
Friend
Job Board / Southern Website
Flyer
Dorm Worship
Submit
Clear
LEAD Program
Photos
Testimonies
Videos