Academic Advisor/Facilitator/Mentor & Coordinator Application

Academic Advisor/Facilitator/Mentor & Coordinator Application Form

Thank you for your interest in Serving LAMP Training, If you have any questions, feel free to contact the Local Learning Site Coordinator or LAMP main Office at 18274 NW 21st Street. Pembroke Pines, Florida 33029. (954) 816-5813.
Select All That Apply*
- Select All
- Facilitator
- Mentor
- Coordinator
- Academic Advisor
Prospective facilitators desiring to teach at LAMP Training must file a formal application with LAMP Main office and submit the following credentials:
- Completed Facilitator Application Form below. A completed and signed application must be submitted to LAMP Main Office
- Academic Degree earned. Copy of Diploma from all institutions you are a graduate. (not necessary for Learning Site Coordinator, but helpful)
- Professional Resume. Copy of a professional resume.
- Photograph. We would appreciate a recent photography or snapshot to be sent with your application and permission to use it in our publications. (preferably in electronic format)
If you have any questions, feel free to contact the Learning Site Coordinator or the LAMP Office
LAMP Training does not discriminate on the basis of race, color, national or ethnic origin, or physical handicap in its educational programs or activities, including admission and employment. LAMP Training does not discriminate on the basis of sex in admission to or employment in its educational programs or activities except as required by the doctrinal standards set forth in LAMP statement of faith “Doctrines of Grace” Because the LAMP program is a Christian Institution, it is fully permitted to select Facilitators on the basis of their religion.
Personal Information
Name
First Last
Phone
Applicant Email
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Learning Site
Birth Date
MM slash DD slash YYYY
Marital Status
- Married
- Single
- Widowed
- Divorced
Name Of Spouse
First Last
Name Of Children
Racial or Ethnic Group
- American Indian/Alaskan
- Hispanic/Latino
- Asian/Pacific Islander
- White/Caucasian
- Black/African American
- Other
This information is voluntary and will not be used when considering for Application
Gender
- Male
- Female
Course Objectives
What is your main purpose for Teaching/working in LAMP?
When do you wish to start?
MM slash DD slash YYYY
What courses will you teach?
Church Affiliation
Earned Academic Degrees
Date of Ordination
MM slash DD slash YYYY
Current Ministry Position
Former Ministry Positions
Three Personal/Ministerial References
Reference 1
Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email
Phone
Reference 2
Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email
Phone
Reference 3
Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email
Phone
I affirm that the information provided in this application is true and accurate to the best of my knowledge.
Signature of Applicant*
Date*
MM slash DD slash YYYY
CAPTCHA
Photo Upload
Drop files here or

Accepted file types: jpg, png, pdf, Max. file size: 64 MB.
Diploma Upload
Drop files here or

Accepted file types: jpg, png, pdf, Max. file size: 64 MB.
Professional Resume Upload
Drop files here or

Accepted file types: jpg, png, pdf, Max. file size: 64 MB.
Academic Degree Upload
Drop files here or

Accepted file types: jpg, png, pdf, Max. file size: 64 MB.
Name
This field is for validation purposes and should be left unchanged.

Academic Advisor/Facilitator/Mentor & Coordinator Application Form

Personal Information

Course Objectives

Three Personal/Ministerial References