LU Part-Time Application - Desperation Students

Name*

First Middle Last

Address*

Street Address Address Line 2 City State ZIP Code

Phone*

Phone

Email*

Enter Email Confirm Email

Instagram Username*

Gender*

Male
Female

Date Of Birth*

Do you attend Desperation Church?*

Yes
No

Father/Legal Guardian*

First Last

Phone

Email

Mother/Legal Guardian*

First Last

Phone

Email

The part-time Leadership U pathway is specifically designed for students who are involved in a school activity/sport that prevents them from applying for the full-time program. For this reason, please provide the following information:

School Activity/Sport*

School Activity/Sport Sponsor Name*

School Activity/ Sport Sponsor Name*

School Activity/ Sport Phone Number*

School Activity/Sport Email*

Do your parents support your membership in Leadership U?

Yes
No

If accepted, do you understand that you are making a 7-week commitment?*

Yes
No

Do you understand that your $125 tuition for this semester is non-refundable should you leave Leadership U?*

Yes
No

Are you aware that you can request up to 2 days off this semester?*

Yes
No

I certify that this information is complete and accurate. I understand that making false or fraudulent statements within this application will result in disciplinary action and denial of admission.

By signing this document I understand and agree to the terms listed above.

Signature*

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Apply for the Summer Semester of Leadership U Part-Time

Leadership U Part-Time Application