2016-2017 Application for Radical Faithfulness Program

Please complete all parts. We need all of the following before we can consider your application:

Completed Application Form
Responses to application questions A-E

Optional: One or two letters of recommendation addressed to Steve Chase, Director of Education
(may be sent separately and by email to schase@pendlehill.org)
Financial aid application, if you are applying for a scholarship

Question Title

* 1. Please select your session

Question Title

* 2. Personal Information

Name *

Company/School (if any)

Address *

Address 2

City/Town *

State/Province *

ZIP/Postal Code *

Country *

Email Address *

Phone Number *

Question Title

* 3. Date of Birth

Date of Birth

Date

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* 4. Skype Address (if any)

Question Title

* 5. Best Days/Times to Call You

Day/Time

Question Title

* 6. Present Occupation

Question Title

* 7. Previous work and volunteer experience (Feel free to email a text version of your current resume)

Question Title

* 8. Education

School or Learning Experience

Degree Earned

Major Course of Study

School or Learning Experience

Degree Earned

Major Course of Study

School or Learning Experience

Degree Earned

Major Course of Study

Question Title

* 9. Please rate your fluency in speaking and understanding American English.

Excellent

Good

Fair

Poor

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* 10. Other Languages

Question Title

* 11. Special Needs

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* 12. Do you have any dietary restrictions

Yes

If yes, please specify

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* 13. Ethnicity/Race: Select one or more of the following races: (optional)

American Indian or Alaska Native

Asian

Black or African American

Native Hawaiian or Other Pacific Islander

White

Hispanic or Latino/a

Question Title

* 14. Religious Affiliation (optional)

Faith Tradition

Denomination

Home Worship Institution

Question Title

* 15. If Quaker (optional)

Monthly Meeting

Yearly meeting

Letters of recommendation are helpful, but not required. Still, such optional documents can strengthen your application so please consider having one or two letters of reference sent in to support your application. The purpose of the letters is to help the admissions committee understand you better as a person: your strengths, your weaknesses, how you are likely to contribute to this learning community and engage in prophetic activism and civic engagement after the program, and anything else that may help us get to know you. It is not necessary – or desirable – to have your references include only complimentary statements. Generic statements that you are in good standing at your religious congregation or job are also not enough; we seek to know you as an individual. Please choose your references carefully if you decide to submit them.

The letters should be included with this application or sent directly by your reference people to:

Director of Education, Pendle Hill,
338 Plush Mill Road
Wallingford, PA 19086-6023
USA

They may also be emailed directly to the Director of Education at schase@pendlehill.org.