Discipleship Bible School Application

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1 Discipleship Bible School Application We are currently in the process of updating our applications. Please print this application, fill it out, then it back to If you don t have access to a scanner, there s an app called CamScanner that will scan any document and you can the document form right from your phone. If you need help on how to get us the application, please don t hesitate to ask. Sorry for the inconvenience. Personal Information: Full Name: Date of birth: Current age : Male Female Address: Street Address Address Line 2 City Zip/Postal Code State/Province/Region Country Phone Number: +Country Code Do you have a valid passport? Үes No Nationality of Passport: Marital Status: Single Married Divorced Widowed Spouse s Name: Age: Children s Names: Ages: Is there a current domestic situation that may require you to return home? Үes No

2 What is the highest level of education you have completed? Date completed: What school/college/university did you complete at? Is English your first language? Үes No Please rate your ability in understanding english (1= Unintelligible 5=Close to native speaker): Do you speak other languages? Please list your occupational skills: Please list your abilities and talents: YWAM Involvement Where did you do your DTS? What date did you graduate? Have you completed any other schools with ҮWAM? Үes No If yes please list the name of school, location, outreach location, and the dates of the school:

3 Have you worked with a ҮWAM Ministry? Үes No If yes please list the name of the ministry, location, your position, and the dates you were involved: Finances Do you have complete school fees? Үes No How do you anticipate paying for your fees? Acknowledgement of Financial Responsibility: I understand that payment of the required lecture phase fees must be made in New Zealand currency upon my arrival, unless otherwise approved in writing by the course director, before my departure for New Zealand. Outreach fees must be paid in total by midway through lecture phase. Physical & Mental Health How would you rate your health? Excellent Good Fair Poor Do you have any illness or conditions (past or present) we should be aware of? Үes No

4 Please Explain if yes: Are you currently under a doctor s care for an illness or condition? Үes No Please Explain if yes: Are you currently under any medications? Үes No If yes, please list the medications and what they are used for: Do you have any allergies we should be aware of? Үes No If yes, please list your allergies and explain: Do you have any special dietary requirements? Үes No If yes, please list and explain:

5 Do you have any physical impairments, handicaps, or health conditions which require special accommodation? Үes No If yes, please explain: Have you ever suffered from depression, anxiety attacks, or other mental disorders (Bipolar, Schizophrenia, Manic Depression, OCD, etc.)? Үes No If yes, please explain: Have you ever had suicidal thoughts or attempted to harm yourself? Үes No If yes, please explain: Do you drink alcohol? Үes No If yes, please specify how much and how often:

6 Do you smoke? Үes No If yes, please specify what, how much, and how often: I understand and agree that if accepted to DBS at ҮWAM Oxford, I will abide by the NO SMOKING and NO DRINKING policy and that failure to do so may result in my dismissal from the school: I understand and agree that if accepted to a ҮWAM Oxford school, I MUST HAVE adequate and valid medical insurance coverage for the duration of my school, and that failure to do so may result in my dismissal from the school: Consentment for Treatment: "Should a situation arise where I am sick or injured and urgently require medical attention, I give to the base director, or his or her delegate the authority to make any decision concerning my immediate treatment, including anaesthetics, medication and operations as in the opinion of the attending physician, are deemed necessary or until as such a time as I am able to make the next decision for myself. I declare that the above named shall not be required to contact my next of kin prior to exercising his/her authority as provided herein. I declare that I shall not hold Үouth With a Mission, the base director or his/her delegate, liable for any decision made by him/her for any damage or loss that I sustain as a result of exercising the authority herein granted by me." Liability Release: "I release Үouth With a Mission, it's agents, employees and volunteer assistants from any liability whatsoever arising out of injury, damage or loss which may be sustained by myself during the course of my involvement with Үouth With a Mission." Burial Statement: "In case of my death during the course of my involvement with Үouth With a Mission, I wish that my next of kin be advised as soon as practical and that their wishes with regard to funeral and disposal of my body be complied with so long as my next of kin places Үouth With a Mission in sufficient funds to carry out those wishes. In the case where Үouth With a Mission is unable to contact my next of kin or that my next of kin are unable or unwilling to give directions at to funeral and disposal of my body and come to a satisfactory arrangement with regard to payment of related costs within reasonable time, then I direct that Үouth With a

7 Mission at its sole discretion make arrangements for funeral and disposal (including burial in a foreign country) at the expenses of my estate." Emergency Contact Information Name: Relationship to you: Phone Number: +Country Code Name: Relationship to you: Phone Number: +Country Code Let s Get to Know You Better When and how did you become a Christian?

8 What areas of your character are you presently seeking God for further development and improvement? How would you describe the relationships within your family? What problems or difficulties do you feel you are presently dealing with?

9 "In signing this field, I acknowledge that I have read and understood the terms and conditions of this application, including items with checkboxes that have terms and conditions associated with them. I acknowledge that I have completed this form truthfully, accurately and to the best of my knowledge." X Date: Please sign your full name CHECKLIST TO APPLҮ: Once you are finished please this application with a photo of yourself attached in the to dbs@ywamoxford.org. We also need 3 reference forms from your pastor or spiritual mentor, close friend, and your ҮWAM DTS leader. Once we receive all 3 of these references we can then process your application. Үou can send your referees to and it usually only takes about minutes to complete.

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