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Student Application

Step 1 of 6

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Name*
First Last
Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Phone Number
Gender*
Email*
Date of Birth*
Section Break
Pastor/Spiritual Mentor Name*
First Last
Pastor/Spiritual Mentor Email*

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DTS Information
Select your DTS elective*
Personal Information
Nationality/Citizenship*
Marital Status*
Are you and your partner applying for the same course?*
- Yes
- No
Partners Name*
First Last
Do you have any dependents that will be coming with you?*
- Yes
- No
i.e. children or special needs adults
Dependent's Information (Please include name, date of birth, gender and special needs if any)*
Are you applying with friends for the same course?*
- Yes
- No
Please list your friends names*
Do you have any musical ability or other talents we should know about?*
First Language*
Please specify your Proficiency of the English language*
Other Languages
Please list all previous YWAM experiences, include the Course name, Date, location, and Directors name.*

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Emergency Contact
Name*
First
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Email*
Relation to you*

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Home Church
Church Name
Pastor
Phone Number
Email
Personal History
Please answer these questions in as much detail as you can.
How did you become a Christian?*
Describe your current relationship with the Lord.*
Do you feel you are called to a particular ministry?

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Personal Health and Wellbeing
Please answer each of the following with as much detail as is helpful for us. Write N/A if not applicable.
Are there any adverse issues that have affected you? (Physical/sexual abuse, divorce, trauma/accidents etc)*
- Yes
- No
a) If 'Yes' to the above, which issues? Please explain how you have dealt with or are dealing with these issues.
Are you presently struggling, or have you previously struggled in the past with any strong addictions such as alcohol, sexual relationships, drug abuse (pot, cocaine, heroin etc), eating disorders (anorexia, bulimia) or self harming?*
- Yes
- No
a) If 'Yes' to the above, which issues? Please explain how you have dealt with or are dealing with these issues.
Have you ever struggled with any mental health conditions? For example: Depression, Anxiety, (Or Anxiety attacks), Self Harm, Suicical thoughts/attempts, PTSD, OCD, Bipolar, Autism Spectrum Disorder, Schizophrenia, Dissociative Identity Disorder, Borderline Personality Disorder.*
- Yes
- No
a) If 'Yes' to the above, please specify which condition(s)
b) Please explain any further details if you are comfortable to do so. For example, how recent this was a struggle, extent/severity, triggers, what seems to help etc.
c) Have you been clinically diagnosed for any of the above conditions?*
- Yes
- No
d) If 'Yes' to being diagnosed, please specify which condition(s)
Do you have any chronic conditions (medicated or unmedicated)? For example: Asthma, Hypertension, Arthritis, Heart disease, Bipolar, Attention-deficit/hyperactivity disorder (ADD/ADHD)*
- Yes
- No
Please state which condition(s), how this impacts you and how you are treating/managing it:*
Are you currently being treated by a mental health professional? (Including Psychiatrists, Psychologists, Counselor, etc)*
- Yes
- No
a) If 'Yes' to being treated, please specify:
Are you currently taking any doctor prescribed medication(s)?*
- Yes
- No
a) If 'Yes' to medication(s), please give details:
Have you ever been involved in a crime? Do you have a police record?*
- Yes
- No
a) If 'Yes' to the above, please give details:
Are you involved in any current or pending lawsuits/legal proceedings?*
- Yes
- No
Do you smoke?*
- Yes
- No
YWAM Zion has a NO SMOKING policy and students are expected to quit either prior to participation in the course, or while in the program.
Do you have any physical handicaps, limitations, or health conditions which may require special attention? Have you had any major surgery in the last 5 years?*
- Yes
- No
a) If 'Yes' to the above, please specify. Please also share how you are managing this or intend to manage it while in the program:
Do you have any specific dietary needs?*
- Yes
- No
Dietary needs include food allergies, vegetarianism, veganism, pescatarianism, and anything requiring food preparations asides from the standard meal* on campus. *YWAM Zion is able to cater to certain food allergies and vegetarianism**. **Depending on the kind of dietary needs listed, you may be required to pay the increased meal fee in order to factor in more expensive substitute meals.
Please list dietary needs*

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Finances
Do you have your complete school fees?*
- Yes
- No
Do you have financial support?*
- Yes
- No
Will you have enough to cover your lecture phase fees before the start of the DTS?*
- Yes
- No
If you do not have the fees and do not have support, please state how you intend to pay for your course:
Information For Us
How did you hear about YWAM Zion?*
Upload a passport style photo*
Please upload a photo with only you in it where we can clearly see your face.

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