Part Time MDTS Application Form

1- Name *
1- Name
Select one option in the list
4- Applicant Birth Date
4- Applicant Birth Date
5- Applicant Gender
6- Applicant Mobile Phone
6- Applicant Mobile Phone
eg: 758-###-####
7- Applicant Home Phone
7- Applicant Home Phone
eg: 758-###-####
P.O. Box or Community, Town etc
10- Program Starting Date
10- Program Starting Date
Select in the list
12- Partner Name
12- Partner Name
13- Person to Contact in case of Emergency
13- Person to Contact in case of Emergency
P.O. Box or Community, Town etc
15- Emergency Contact Mobile Phone
15- Emergency Contact Mobile Phone
eg: 758-###-####
16- Emergency Contact Home Phone
16- Emergency Contact Home Phone
eg: 1-758-###-####
18- Do you have Children you are taking care of or coming with you?
Most church are affiliated to a larger denomination body (such as : Baptist, Evangelical, Pentecostal, etc... if not They are INDEPENDENT
21- Pastor Name
21- Pastor Name
P.O. Box or Community, Town etc
25- Church Office Phone
25- Church Office Phone
758- ###-####
indicate: duration such as 7 months, 4 years, etc...
eg: worship, children, cef, iccf, other (you can enter multiple ministries)
28- Do you have all the money required for this school/program?
Please list anything from practical skill professional expertise to spiritual gift that you know
33- Referee Name
33- Referee Name
Give us the name and contact of a mature Christian who answer a few question about you
P.O. Box or Community, Town etc
36- Referee Mobile Phone
36- Referee Mobile Phone
758-###-####
what is this referee relationship with You: it could be; FRIEND, EMPLOYER, PASTOR, LEADER, etc... a reference form will be send to him or her to complete
- Do you have any health issue that requires special attention? - Do you have any Food or drug Allergy please indicate! - do you have any physical disability we need to know of? - Are you taking a special medication
39- I certify that all information in this application is complete and accurate and If accepted by Youth With A Mission Saint Lucia. I will abide to the best of my abilities by the Spirit, rules and schedule of the program. I confirme that I understand that the payment of the required program fees/tuition must be made before its start and I am fully aware of my obligations before God and to YWAM. *
40- I commit to solve any offence or misunderstanding occuring during my time at the base in accordance with the biblical principles in Matt 18: 15-17 / Matt 5:23-24 *
41- Application Completed by *
41- Application Completed by
42- Application Completed on
42- Application Completed on
indicate the date you completed this application

Please Submit Application above before proceeding to personal questions