CROSSROADS DISCIPLESHIP HOME

To apply for the CDH program, please complete the following steps:

Step 1 - Fill out the application below. This is the initial step in a series of of steps to acceptance into the program.

Step 2 - Submit 4 references using our Reference Form.

      References should include:

  • Pastoral- A spiritual leader in your life
  • Personal- Someone 25 or older, other than your parents, who can speak to your character traits
  • Parental/Guardian
  • Friend- Your closest friend

Once we receive your application and the reference forms, we will contact you about next steps in the application process. Please feel free to contact us if you have any questions. We're praying intently for the upcoming CDH12 program year.

Personal Information
Name *
Name
Phone *
Phone
Address *
Address
Do you have a car?
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Personal History
Have you ever been arrested or convicted of a felony? *
Have you ever been convicted of a crime of child abuse, or a crime involving actual or attempted sexual molesteation of a minor? *
Have you ever been under a doctor's care for any mental illness such as depression, anxiety disorders, etc? *
If you answered yes to any of the above questions, have you had professional counseling or rehabilitation? *
Answering yes to any question doesn't necessarily exclude you from the selection process and all answers are kept confidential so please be honest.
Biographical questions
Please answer the following questions in 250 words or less.