Student Application

Full Name

Phone

Address

City

State

Zip Code

Gender

Male

Female

Are you a member of a church?

Yes

Name of parent(s) or guardian(s)

Email of parent(s) or guardian(s)

Denomination

Address of parent(s) or guardian(s)

Phone number of parent(s) or guardian(s)

Name of church you attend

Non-Relative Emergency Contact Name

Relationship of Emergency Contact

Emergency Contact Phone Number

Employment History

Name of most recent employer

Dates Employed

Position

Reason for leaving

Medical History

Do you have a history of mental illness, depression, epilepsy, anxiety or anything that requires regular medical attention?

Yes

If yes, please explain.

Name of psychiatrist or doctor consulted

Phone number of psychiatrist or doctor

Address of psychiatrist or doctor

Spiritual Life

Please list ministries in your church and community that you have served in and the length of time that you served.

Greatest Strength?

Explain how you feel the Lord is leading in your life.

Area where you would like to see God make a strength in your life?

What are your gifts and talents?

Have you ever shared the gospel with anyone before? If yes, please tell us about it.

What are you expecting from a Global Year?

Do you have any experience in missions? If yes, please describe being sure to include the year(s) you went, country(ies), length(s) of time, and what you did there.

References

Full name

Email address

Phone

What is your relationship to this person?

Full name

Email address

Phone

What is your relationship to this person?

Pastor/Mentor's Name

Email address

Phone

How long has this person been your pastor/mentor?

Education Experience

What year did you or will you graduate from high school?

Schools/Colleges/Universities

Years of attendance

Year graduated

Degree

Personal Testimony

How did you hear about Global Year?

Why do you want to go on this trip?

Upload clear photot of yourself

Upload File

If possible please upload passport photo (section that has photo of you with signature))

Upload File

Thanks for submitting!