YWAM Nanaimo Student Application
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Course Applying For: *
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PERSONAL INFORMATION
Given Names: *
Surname: *
Gender: *
Required
Are you married or have children accompanying you? *
If yes, please list names and birthdays. *
Date of Birth *
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Country of Citizenship: *
Country of Birth *
Email: *
Phone Number: *
Facebook URL *
Instagram URL *
Highest level of education completed: *
Have you completed any previous training with YWAM? *
Current Occupation: *
MAILING ADDRESS
Apt/ House Number: *
Street: *
Town / City: *
Province / State: *
Postal / Zip Code: *
Country: *
MINISTRY INFORMATION
Describe your journey to become a Christian and what Jesus means to you. *
What is your heart behind applying to this program at YWAM Nanaimo? What do you desire to get out of the course? *
What do you consider to be strengths in your character? What are some areas you are looking to grow or develop? *
Please describe your spiritual or ministry goals you have for yourself. *
A course workload can include in class learning, small group learning, individual learning & self study, and community volunteering. With this in mind, can you describe how you think you will handle a busy schedule and workload? *
How is your relationship with your family? Are they supportive of your involvement in missions? *
What church involvement have you had? (Include YWAM involvement) *
Is your church supportive of your choice to do YWAM? *
How did you hear about YWAM Nanaimo: *
Skills, Hobbies, Interests: *
Do you currently have your complete course fees? *
If not, how do you anticipate the fees to be paid?
Do you currently have up to date vaccinations: *
Do you have any criminal convictions: *
EMERGENCY CONTACT INFORMATION
Please provide information for a contact in the event of an emergency.
First Name: *
Surname: *
Phone Number: *
Email: *
Address: *
Relationship To You: *
YWAM Agreements
Please read the following and if you are unsure of its meaning contact us for more explanation. The undersigned does hereby consent to taking part in noted activity organized by YOUTH WITH A MISSION-YWAM (herein referred to as YWAM), a religious non-profit corporation, with full understanding insofar as such  activity will involve missions and sporting activity and mingling with other individuals and groups, that treatments,  and incidental loss and expense, and the undersigned does for him/herself assume the risk of such expense, does wholly release YWAM from any responsibility or liability, and waives any claims or causes of action against it, it’s agents, it’s employees, or volunteer assistants that might arise on account of loss, injury or expense occasioned by  any sort of accident or other circumstance involving him/herself and agrees to hold harmless YWAM in the event any  such claims should arise; and  The undersigned agrees to abide by the rules and regulations, supervision and discipline set and applied by YWAM  and it’s agents, and does hereby authorize YWAM or it’s staff members or other agents to arrange for and consent to  x-ray examinations, anesthetic, dental, medical or surgical diagnosis, and treatment, and hold harmless YWAM for  any such. The undersigned will furnish payment or insurance for any such payment, at his/her own expense. *
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