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Student Application Form

First Name

*as Per Passport

Last name

*as Per Passport

Email

Phone

please include country code e.g. (NZ) +64

Country/Region

Address

City

Zip / Postal code

COURSE DETAILS

Which course are you applying for?

How did you hear about YWAM Te Ao Marama?

Please share why do you want to take this course?

Please describe your current relationship with God

Life & Background

Nationality

Date of Birth

Day

Month

Year

Please upload a photo of yourself - Make sure we can recognize you

Current Relationship Status

Family Info

If your partner and/or children will be accompanying you to the DTS please state their names and age

Emergency Contact

Name

Last Name

Relationship to you

Emergency Contact Phone Number

Please include country code e.g. (NZ) +64

Are you currently taking any medication?

YES

NO

Do you have any allergies?

YES

NOT THAT I KNOW OF

Have you ever been diagnosed with any form of mental illness?

YES

NO

Have you ever been convicted of, or charged with, a criminal offence?

YES

NO

Have you had any addictions to drugs, alcohol, porn, smoking, vaping or had same sex attraction in the last 3 years?

YES

NO

Do you have any dietary restrictions?

NO

YES

e.g. dairy free, gluten free, etc

How well do you speak English?

Do you speak any other languages? Please list them

Do you have a current passport?

YES

NO

In Process

PASSPORTS NEED TO BE VALID FOR 6 MONTHS AFTER YOUR DEPARTURE FROM NEW ZEALAND.

Do you have the full training phase fees?

Yes - I have all funds

Partial - I have part of the funds

No funds yet

Do you have the full outreach phase fees?

Yes - I have all funds

Partial - I have part of the funds

No funds yet

CHARACTER REFERENCES

As part of the application process for our courses we require two character references, with one being from either a pastor, leader or trusted Christian mentor in your life.

It’s advisable to include trusted people in your decision-making process. Those who fill in your reference form should have a genuine interest in your life and insight into the steps that you are taking.

Please note, by providing this reference information you are confirming that these individuals are willing to be contacted regarding your application.

FIRST REFERENCE

First Reference: First Name

First Reference: Last Name

First Reference: Phone Number

First Reference: Email Address

SECOND REFERENCE

Second Reference: First Name

Second Reference: Last Name

Second Reference: Phone Number

Second Reference: Email Address

I agree that all information I have entered is true and correct. I accept that if this is not the case it may affect my acceptance into this course.

Any final comments before submitting your application?

Feel free to include anything you believe is important for us to know prior to acceptance.

A NEW JOURNEY IS ABOUT TO BEGIN