Statesmen Academy 2023 Application

July 18-22, 2023 • West Palm Beach, Florida

Please complete all fields and click the submit button.

First and Last Name

Personal Email

Date of Birth

Gender

male

female

Home Address

City

State & District

Zip Code

Cell Phone Number

Occupation

Spouse's Name (if applicable)

Children (if applicable)

Official Website Address and Social Media Handles (if applicable)

Campaign Website Address & Social Media Handles (if applicable)

Personal Social Media Handles

Volunteer and Public Service (non-elected positions)

Church and other Religious Involvement

Please describe your faith journey.

Current Office held- Please include: District, Year First Elected and Total Years in Office.

Prior Office Held- Please include: District, Year First Elected and Total Years in Office.

If you have held any leadership position(s) while in office, please list them here along with the years served.

If you are an elected office holder please describe why you ran for office. If you are not yet elected please describe your commitment to run for office in the future.

Personal Reference 1 - Name | Email | Phone Number | Relationship To You

Personal Reference 2 - Name | Email | Phone Number | Relationship To You

Personal Reference 3 - Name | Email | Phone Number | Relationship To You

Family Policy Foundation is committed to the following Statement of Faith. Please review the statement and if you are in agreement with it, check the box that follows. We believe the Bible to be the inspired, only infallible, authoritative Word of God; We believe that there is one God, eternally existent in three persons: Father, Son and Holy Spirit; We believe in the deity of our Lord Jesus Christ, in His virgin birth, in His sinless life, in His miracles, in His vicarious and atoning death through His shed blood, in His bodily resurrection, in His ascension to the right hand of the Father and in His personal return in power and glory; We believe that for the salvation of lost and sinful humanity, regeneration by the Holy Spirit through faith in Jesus Christ is absolutely essential; We believe in the present ministry of the Holy Spirit by whose indwelling the Christian is enabled to live a godly life; We believe in the resurrection of both the saved and the lost, they who are saved unto the resurrection of life and they who are lost unto the resurrection of damnation; We believe in the spiritual unity of believers in our Lord Jesus Christ.

If you disagree with any of these statements, please explain why.

Release: I consent to the use of my name, photograph, and video in materials to market the Statesmen Academy.

I hereby certify that the above information, to the best of my knowledge, is correct. I understand that falsification of this information may prevent me from being accepted into the Statesmen Academy. I am providing my signature by typing my name in the box below.

Full Name

Today's Date

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Statesmen Academy 2023 Application

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