Create School Application

Applying for: *

First Name: *

Last Name: *

Address: *

Zip: *

City: *

State / Province:

Country: *

Phone: *

Email: *

Birthday: *

Gender: *

Male

Female

Nationality: *

Marital Status: *

Single

Married

Name of Spouse:

If married, has your partner applied to complete this DTS:

N/A

Yes

Name and age of children (i.a.):

If you have a boyfriend or girlfriend, have they applied to complete this DTS:

N/A

Yes

If yes, what is his/her name:

I Agree: *

Yes

Bullimia: *

Yes

If yes, specify:

Anorexia: *

Yes

If yes, specify:

M.E.: *

Yes

If yes, specify:

Chronic Fatigue Syndrome: *

Yes

If yes, specify:

Anaemia: *

Yes

If yes, specify:

ADHD: *

Yes

If yes, specify:

Learning/writing disability: *

Yes

If yes, specify:

Recreational drug or alcohol abuse: *

Yes

The DTS is to be free from alcohol, smoking and recreational drug use. Do you accept this? : *

Yes

Have you ever been convicted of a criminal offence (excluding traffic infringements): *

Yes

If yes, specify:

Are you awaiting the hearing of charges in a civil or criminal court of law?: *

Yes

If yes, specify:

First Name: *

Last Name: *

Address: *

City: *

Relationship: *

Phone: *

Home Church Name: *

Leader's Name: *

Phone: *

Your Pastor or Mentor. Name: *

Email: *

A Leader for example Cell Group Leader, Youth Group Leader or similiar. Name: *

Email: *

English Rating: *

Other:

Rating:

Other:

Rating:

If English is not your Mother Tongue, have you ever taken an English Language Test:

N/A

Yes

Date taken:

Score/Grade:

Did you receive any help completing this form:

N/A

Yes

If yes, specify:

What percentage of the Lecture Phase fees do you presently have?: * %

What percentage of the Outreach fees do you presently have?: * %

If not 100%, what plans or resources do you have to meet the outstanding fees:

Why do you desire to take part in the Oak Ridge DTS Program?: *

How did you first hear about YWAM?:

How did you first hear about Oak Ridge?:

What reasons most influenced your decision to apply here at Oak Ridge: