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Have you applied to this school before?
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If yes, where you accepted?
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If you were previously accepted, why did you not attend? If you where not accepted, why? (to the best of your knowledge)
Martial Status
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Please describe your current family situation.
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Emergency Information
Emergency Contact Name
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Address
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Street Address
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State / Province
Postal / Zip Code
Please Select
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Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
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Argentina
Armenia
Aruba
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Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
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Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
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Guinea
Guinea-Bissau
Guyana
Haiti
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Hong Kong
Hungary
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India
Indonesia
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Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
E-mail
*
Ministry Information
Are you currently involved/serving in a local church?
*
Yes
No
If yes, how long?
If no, have you ever been involved in the past?
List significant volunteer activities in the last 3 years:
*
What do you feel are your talents, gifts, and strengths?
*
What do you feel are some of your weaknesses?
*
How do you plan on paying for your Gap Year Program?
*
Health Information
Please mark if you have had any occurrences of the following within the past 18 months, whether mild or severe
*
Yes
No
ADD or ADHA
Drug abuse
Sleeping Disorder
Alcohol abuse
Tabaco
Asthma
Mild depression
Prescription drugs
Diabetes
Chronic depression
Eating disorder
HIV/AIDS
Long-term medication
Chronic pain
Seizures
Allergies
Chronic fatigue syndrome
Other medical conditions?
If you checked any of the boxes above, please explain.
Are you currently on or have you ever been on medication for a mental or emotional illness/disorder?
*
Yes
No
Please explain.
Do you have a police record?
*
Yes
No
Please explain.
Acknowledgement and Agreement
Click to edit
*
I have read, agree with, and will abide by the Gap Year Program Expectations.
I have read, understand, and will adhere to the Gap Year Program Guidelines.
I understand that I must secure funds to cover all my tuition before attending the Gap Year Program.
I understand that I must secure funds sufficient to cover all my personal expenses.
I declare that the information I have provided in my application is true, accurate, and complete and that false information in my application may be grounds for denial of my application and/or dismissal
My Full Name as Signature
*
First Name
Last Name
Date and Time
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Month
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E-mail
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Phone Number
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Area Code
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