Education and Experience
Highest Level of Education
High-School Diploma Some College College Diploma Graduate/Post Graduate
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What is your current status
I have a job I am in school I am on staff with YWAM In transition
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When and where did you graduate from DTS?
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Descirbe your experience on DTS outreach.
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Please describe any special skills, talents or abilities that you have.
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Please list the languages you speak in order of fluency.
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Background Information: The following questions are for the purpose of getting to better know where you've come from. Your responses will not be used to deny acceptance.
Please indicate if you have ever been involved in any of the following:
Religions other than Christianity The occult,Wicca,witchcraft,sorcery,Ouija boards,etc Felonious crime
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If you indicated Yes to any of the above, please explain
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How we express our sexuality has much to do with our walk with Christ. Have you been involved in any sexual practices outside of marriage? (for example: promiscuity, homosexuality, pornography)
Yes No
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If you indicated Yes, you may explain as little or as much as you would like to.
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HEALTH HISTORY : The following information will be treated as confidential. You may be asked to provide further detail regarding incomplete explanations of health conditions prior to acceptance. The omission of health problems could result in your application not being considered or a re-evaluation of acceptance.
Height
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Weight
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Rate your overall heath
Very Good Good Fair Poor
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Are you currently under a doctor’s care for any condition?
Yes No
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If yes, please explain.
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Are you presently taking any medication (prescription or non-prescription drugs)?
Yes No
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If yes, please give the name of the medication and the condition it treats.
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Please describe any allergies (medicines, food, other) that you have.
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Are there any physical limitations or health conditions that require special attention of which we should be aware?
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Please indicate if you have had issues with any of the following:
depression, panic attacks, extreme anxiety eating disorders (anorexia, bulimia,etc) self-injury (cutting, burning, wounding,etc) alcohol or alcohol abuse habitual smoking or tobacco use drugs or drug abuse
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If yes to any of the above, please explain
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Please explain if you have ever participated in any form of counseling (for example: clinical, personal, grief, family, group or individual, etc.).
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Please explain any other important past surgeries, illnesses, injuries, or other physical or emotional health issues that we should know about
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