STUDENT APPLICATION
Part 1
Application takes approximately 5-10 minutes to complete.
I plan to enter Revolution Five:
*
Please Select
Fall of 2026 (Class of 2027)
Fall of 2027 (Class of 2028)
GENERAL INFO
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Gender
*
Please Select
Male
Female
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Are you a U.S Citizen?
*
Yes
No
Please check all that apply.
*
High School Senior
College Graduate
High School Graduate
Part-Time College
College Freshman
Full-Time College
College Sophomore
Employed
College Junior
Unemployed
College Senior
N/A
Other
Please provide month/year of high school graduation.
*
If you dropped out of high school, specify here.
Please provide month/year of college graduation.
High School GPA
*
College GPA
Do you intend to pursue a degree?
*
Yes
No
Please specify your degree.
Please specify the name of your college.
Are you currently employed?
*
Yes
No
Please provide name of employer.
What is your fitness level?
*
Please Select
Great
Good
Average
Poor
Prefer not to say
Tell us about your workout routine.
How do you plan to pay for your tuition?
*
How did you hear about Rev5?
*
Family
Rev5 Alumni
Friend(s)
Social Media
College
Website
Coworker
Other
To whom do we owe thanks?
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FAMILY BACKGROUND
Father's Name
First Name
Last Name
Father's Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Father's Email
example@example.com
Mother's Name
First Name
Last Name
Mother's Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Mother's Email
example@example.com
Please check all that apply. I currently live with:
*
Parents
Step-Parent
Mother
Guardian
Father
On-My-Own
Other
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ESSAY QUESTIONS
Please answer in 2-3 sentences or more. Share a bit about yourself.
What career do you want to pursue?
*
Describe how you came to know Christ.
*
If selected, what do you hope to gain from your time at Rev5?
*
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PAYMENT
*
Categories:
All
All
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Application Fee
$25.00
$
25.00
Debit or Credit Card
First Name
Last Name
Credit Card Number
Security Code
Expiration Month
January
February
March
April
May
June
July
August
September
October
November
December
Expiration Month
Expiration Year
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
2043
2044
2045
Expiration Year
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Submit
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