DCLS application What session are you applying for?*Fall 2023Fall 2024Personal InformationName* First Last Phone Number* Email* Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Social Media Handles Birthdate* MM slash DD slash YYYY Age* Gender*MaleFemaleMarital Status*SingleMarriedDivorcedSeparatedAre you a citizen of the US? Yes No Have you accepted Christ?* Yes No Do you regularly attend church?* Yes No How long have you attended your church? Name of your Senior Pastor How did you hear about DCLS?* What is your country of origin?* Please list any languages you speak other than English and whether fluent/conversational EducationSelect one, with Highest Degree of Education Completed College Degree Some College High School GED Some High School Name of College Degree Years Attended EmploymentAre you currently employed?* Yes No Present Employer Dates employed List of duties performed HealthPhysical Health Excellent Good Fair Poor List any allergies List any physical limitations Mental Health Excellent Good Fair Poor Please explain why you selected poor Mental Health Diagnoses or StrugglesList any medications you are currently using (optional) Have you ever used illegal drugs?* Yes No Please explain*Do you currently smoke?*This includes vaping, any form of nicotine and use of Marijuana Yes No Please explain*Do you currently drink alcoholic beverages?* Yes No Have you ever been arrested?* Yes No Please explain*CommitmentIf you are accepted to Dream Center Leadership School, are you willing to make a 9-month commitment?* Yes No Do you understand that being a part of DCLS will require you to live at a high Biblical standard?* Yes No List some qualities you think are necessary to be a leader* Please write a brief personal testimony. 200 words minimum*ReferencesReference 1Name* First Last Relation* Phone Number* Email Reference 2Name* First Last Relation* Phone Number* Email Reference 3Name First Last Phone Number Relation Email Dream Center Leadership School2301 Bellevue Ave.Los Angeles, CA 90026 Have a question?Call us at (800) 503-1118Email us at dcls@dreamcenter.org Sign up for emails "*" indicates required fields First Name* Email* Home About Learn Serve Connect Apply © 2022 DCLS