Applying For
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Diploma of Christian Missions Leadership
Which Quarter?
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January
April
July
October
Title
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Mr
Ms
Miss
Mrs
Name
*
First Name
Last Name
Preferred Name
Sex
Birthplace (Country + City)
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Birthday
*
MM
DD
YYYY
Are you Aboriginal or Torres Strait Islander origin?
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No
Yes, Aboriginal
Yes, Torres Strait Islander
Yes, Aboriginal and Torres Strait Islander
Marital Status
Single
Engaged
Married
Seperated
Divorced
Remarried
Widow(er)
Spouses Birthday
Only answer if you answered: Engaged, Married, Remarried, or Widower
MM
DD
YYYY
Will Your spouse be accompanying you?
Only answer if you answered: Engaged, Married, Remarried
Mailing Address
Is your permanent address the same as your mailing address?
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Is your permanent address the same as your mailing address?
Physical Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Home Phone Number
*
Mobile Phone Number
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Preferred Phone
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Home
Mobile
Email
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Country of Citizenship
City and Country of Passport Issue
Passport Number
Passport Expiry Date
MM
DD
YYYY
Do you currently hold an Australian Visa?
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Visa Type
Visa Number
Visa Expiry Date
MM
DD
YYYY
Emergency Contact First & Last Name
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Relationship
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Parent
Brother
Sister
Friend
Neighbour
Other
Emergency Home Number
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Emergency Mobile Number
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Emergency Contact Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Emergency Email
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Home Church
Pastor's Name
First Name
Last Name
Pastor's Phone Number
Have you ever been convicted of a felony?
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Comment
Have you ever been convicted of a sexual crime?
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Comment
Is English your first language?
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How well do you speak English
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Very Well
Well
Not Well
Not At All
What is the primary language you speak at home?
How long have you studied English?
Have you ever had lectures delivered by a native English speaker?
For how long?
For what class?
Have you had a minimum of three (3) years studying English as a foreign language with a pass rate of at least 80%
When?
For what class?
Have you completed formal independent testing with a minimum level at, or equivalent to, the following: TOEFL: 530 IELTS: 5.0
When?
For what class?
Test of English as a Foreign Language (TOEFL)
International English Language Testing System (IELTS) Score
Other form of testing (please specify) Score
List any other languages spoken and your proficiency.
What is your highest completed school level?
Year 12 or equivalent
Year 11 or equivalent
Year 10 or equivalent
Year 9 or equivalent
Year 8 or below
Never attended school
In which Year did you complete that school level?
Are you still attending secondary school?
Have you SUCCESFULLY completed any any of the following qualifications?
No
Bachelor Degree or Higher Degree
Advanced Diploma or Associate Degree
Diploma (or Associate Diploma)
Certificate IV (or Advanced Certificate/Technician)
Certificate III (or Trade Certificate)
Certificate II
Certificate
Where did you do your DTS and when did you complete it?
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Where did you do your C4CM and when did you complete it?
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Height (in meters)
Weight (in kilograms)
Do you have a disability, medical condition or impairment?
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Specify your disability, medical condition, or impairment
Are you able to walk 5km / 3m in a day?
*
Specify
Can you perform reasonably strenuous work on a daily basis?
*
Specify
Are you currently under medical supervision?
*
Specify
Are you presently taking any medication?
*
Specify name and dosage
Are you allergic to any drugs or medication?
*
Specify drug and medication allergies
Please specify your dietary needs
Do you have any dietary requirements?
*
Do you have, or have you ever had any of the following?
Please check, if applicable and explain below
Please Explain
How would you rate your overall health condition?
How did you first hear of YWAM Gold Coast?
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What most influenced your decision to apply?
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What expectations do you have for this school?
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Please describe your Christian experience and present spiritual relationship with the Lord.
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What areas of your character are you presently seeking God to further develop and improve?
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Do you feel God has given you, or is leading you into a particular area of ministry?
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Briefly explain your relationship with your church, including service and leadership experience
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Are there any unresolved conflicts in your relationships that you can identify?
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How do you feel you adapt and respond to changes in situations and new environments?
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Do you have your complete school fees?
What amount do you have?
Amount needed?
Do you have any significant outstanding debts?
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Explain
Of the following categories, which BEST describes your current employment status?
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Full-time Employee
Part-time Employee
Self Employed - not employing others
Employer
Employed - Unpaid worker in family business
Unemployed - Seeking full-time work
Unemployed - Seeking part-time work
Unemployed - Not seeking work
Of the following categories, which BEST describes your main reason for undertaking this course?
To get a job
To develop my existing business
To start my own business
To try for a different career
To get a better job or promotion
It was required of my job
I wanted extra skills for my job
To get into another course of study
For personal interest or self-development
Other reasons
Pastor Reference Name
*
First Name
Last Name
Pastor Reference Email
*
Teacher Reference Name
*
First Name
Last Name
Teacher Reference Email
*
Friend Reference Name
*
First Name
Last Name
Friend Reference Email
*
