September 5, 2019 - May 23, 2020

Program Fees: Pacific Crossroads Church Members: $2,000 | Non-Members: $2,250
Need-based financial aid is available and applications will be provided to all fellows upon selection to the program. Non-Pacific Crossroads applicants must submit a current church pastor as one of their two references.

Name *
Name
Phone *
Phone
Date of Birth
Date of Birth
Mailing Address *
Mailing Address
Please enter if relevant to your application (e.g. - if you have a portfolio or artwork you'd like us to see/hear)
Please tell us which church you most frequently attend.
(Anything else you feel we should know about to help us evaluate your eligibility for this program.)
Reference 1 (no immediate relatives) - Name *
Reference 1 (no immediate relatives) - Name
Reference 2 (no immediate relatives) - Name *
Reference 2 (no immediate relatives) - Name
Signature: I hereby affirm that the information I have provided on this application is true and accurate. I authorize representatives of the CFWLA to make independent inquiry about me to assess my qualifications regarding this program. Furthermore, I understand that the Fellows program is designed for followers of Christ who desire to be teachable in all areas of life. Please type name to indicate your affirmation and authorization.