Name (surname, first name, middle name)

Present Address

Phone Fax E-mail

Permanent Address

Phone Number Fax Number

Birth Date (D/M/Y)
Gender male female
Nationality/Citizenship
Passport Number
Expiration Date
Place passport was issued
Have you ever been refused a visa? (If yes, give nation and details)

Marital Status single engaged married widowed separated divorced remarried
Name of spouse or fiancee
Is your fiancee applying for this DTS? yes no
Date of Marriage or prospective date if engaged (D/M/Y)

Please give us the following information about yourself.
Age Height Weight Blood Type
In case of an emergency contact (Name)
How is this person /these persons related to you?
Address

Phone Number
E-mail

How would you rate your health?
excellent good average fair poor
Are you presently taking any medication or are you under a doctor's treatment? yes no
If 'yes', please explain

Do you have other allergies? yes no
If 'yes', please describe

Do you have any physical disabilities? yes no
If 'yes', please describe

Are you on a special diet? yes no
If 'yes', please describe

Do any of your children accompanying you have any disabilities or special dietery needs? yes no
If 'yes', please describe

Do you presently use tobacco? yes no
Do you presently have health insurance? yes no
If 'yes', please give the name of your insurance provider
Policy Number
Will your insurance cover you during Phase I and III in Russia? yes no
Will your insurance cover you on Phase II on outreach to another country other than Russia? yes no

Name of church
Name of Pastor
Phone Fax
E-mail Church Address

Does your pastor approve of you attending a YWAM school?
yes yes, with some reservation no
How long have you attended this church?
How would you describe your relationship with your pastor/elder?

To finish processing your application, we will need two references--
one from your pastor, and another from a mature Christian whom you know
well. Please give the name, address, phone and fax numbers, and e-mail
address of your second reference.

What level of education have you completed? (eg. high school, university, etc.)

List degrees and certificates you have earned, and from what institutions.

Please describe your work experience for the last three years, including
the companies you have worked with, and the positions you have held, and
how long you worked for them, up to your present occupation.

What languages do you speak, and in what proficiency?

Please prayerfully answer the following questions. Again,
let us tell you that everything you say in this application
is treat confidentially.

Describe your conversion experience.

How long have you been a Christian?

Briefly describe other experiences you have had as a Christian.

Describe your present relationship with the Lord.

Briefly describe any books you have recently read that have had a significant impact on you.

Briefly describe your relationship to your family, and how they feel
about your intention to attend a DTS.

Comment briefly on the circumstances which led to your decision to apply
for this school. Include any specific guidance you received.

What are your reasons for wanting to attend this school? Include spiritual,
ministry, and/or missionary goals you hope this school will help you fulfill

What are your plans following the DTS?

Have you ever been involved in any of the following--
religious cults, occultism, use of illegal drugs, criminal
activities, and/or alcoholism? If 'yes', please elaborate
and include dates and circumstances surrounding your involvement.

Please list the church you have attended for any considerable length
of time, from childhood to the present. Also, specify the ones of
which you have been a member.

Please any leadership experience you have had, including your responsibilities
and the length of time you were involved.

What missions exposure/ experience/ training have you had (including through YWAM)?

Have you lived in or visited other countries? If so, where and for how long?

Do you think you could live in pioneer situations (different culture, different
food, dormitory housing or small quarters for families)?

Is there anything else you should tell us that would be helpful for us to know

Do you have any questions or comments?

How much money do you have at the present time to go towards your fees?

How much has been pledged by friends, family, and church, but you do not yet have?

How much do you lack towards your fees, including what has not been pledged?

How do you plan to raise the amount you still need?

List any financial obligations or debts you have presently, and how you
expect to fulfill them.