Full Program Application

Request for full program participation

  • You can fill out the application online in its’ entirety, or print the .pdf version of the application here, fill it out by hand, and mail it to the address below:

    Chains of Grace Attn: Application Department PO Box 1344 Midlothian, Texas 76065

  • All information below is kept private and only the selection board will see your answers once submitted.

  • Be advised, this form will take approximately 1 hour to complete and is extensive, but must be filled out honestly and to the best of your knowledge. Thank you and we look forward to reviewing you application for participation.

  • Chains of Grace PDF application here:

Please complete the form below