SBS APPLICATION
We are so excited for you to be a part of our YWAMKC family!
Personal Information
Student name
*
First Name
Last Name
Gender
*
Male
Female
Date of birth
*
-
Month
-
Day
Year
Date
Where did you do your DTS?
*
Phone Number
*
Email
*
example@example.com
Country
*
How is your relationship with Jesus? Tell us your story, challenges, victories, etc.
*
Have you ever been involved in
*
Occult activities/Witchcraft
Same sex inclinations
An eating disorder
Abuse in your family
Sexual abuse
None of the above
Other
Have you ever been convicted of a crime?
*
Yes
No
Please tell us about your criminal record
*
Please describe how you will make financial arrangements for this school (What are your plans to raise funds?)
*
(Ex: Talk to church for financial support, reach out to friends and family as financial supporters, etc.)
Reference Information
Relationship
Please Select
Pastor
Mentor
DTS leader
Name
*
First Name
Last Name
Phone Number
*
Email
*
example@example.com
Health information
Do you have any medical conditions/mental illnesses that require specific attention?
Yes
No
Please explain
Do you have any food allergies?
Yes
No
What is your reaction? (For our kitchen to accommodate allergies, we require a signed doctor's note. Food preferences cannot be accommodate.)
Are you currently taking any medications?
Yes
No
List medications and purpose for use
Submit
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