Partner Application

If you would like to partner with LCPN, please fill out the application below. Click here to make an online donation, or mail your donations to Liberty Church Planting Network, P.O. Box 10174, Lynchburg, VA 24506.

* Note to churches: This application must be completed by the full-time minister/pastor of the church applying for membership.

PERSONAL

First Name

Home Address

City, State, Zip

Last Name

Home Phone

Cell Phone

Date of Birth

Do you currently or have you ever attended Liberty University?

Yes No

If yes, years attended

Graduated?

Yes No

CHURCH/ORGANIZATION

Fill out this section if you are officially representing a church or organization.

Church/Organization Name

Church/Organization Phone

Position at your church/organization

Date of Ordination (required for LU scholarship)

Church Attendance

Church Membership

Church Address

City, State, Zip

Contact Name for Monthly Statements (if different)

Contact's Email

Number of students from your church that attend
Liberty University

LU STUDENT INFORMATION

Fill out this section only if you are interested in the pastor’s scholarship program. You must have already been accepted as an LU Online student or a previous student.

Liberty Student ID#

Liberty Email

Degree Presently Seeking

Anticipated Graduation Date

ELECTRONIC SIGNATURES

By initialing and dating the fields below, you agree to support everything outlined in each document.

I/We have read and agree with the LCPN Doctrinal Statement.