Personal Data of Spouse/Fiancé(e) 
First Name   Last Name   Area Code   Phone Number   
Marriage Details
Date of Legal Marriage:   Date   
Church   Customary   City Council      
Have you been married before?   Yes   No   
If yes;
How many time's      
Date of last marriage       
Date(s) of Divorce(s)      
Number of Children from the previous marriage       

If married before, do you pay alimony or child support?
Yes   No   If Yes, include this amount, if No explain 
   
Do you have children out of wedlock?   Yes   No 
How many do you support?       

Spouse's Spiritual Details
Is your spouse born again?   Yes   No    
Will your spouse be attending RBTCZ?   Yes   No    
Has your spouse previously attended RBTCZ?   Yes   No   
If Yes, which year?   FIRST YEAR   SECOND YEAR 
Did your spouse graduate?    Yes   No     
Is your spouse in agreement that you attend RBTCZ?     Yes   No   
If No, explain why        
Will your spouse (and your dependent family) be residents with you while you attend RBTCZ?   Yes   No   
(We encourage married couples to be in residence together from registration to graduation. We do not encourage the separation of families in order for you to attend RBTCZ) 

Will you be responsible for any dependent(s) during your period of studies?    Yes   No   

If Yes, give details of dependents whom you will be supporting as breadwinner using your earnings, e.g. children or relatives such as grandparent(s
Name and Surname   Age   Relationship   

Answers will not be used as grounds to decline any applicant’s entry into RBTCZ. These answers will be kept confidential by RBTCZ

Are you presently taking any medication?      
If Yes, What type of medication/drug(s)      
How often do you take it?      
Name of the attending physician      
(If you are currently on any medication for any sickness or disorder, a letter of recommendation from your doctor must accompany this application).

Have you taken any drugs for a long period?      
Do you have any known drug allergies?       
Do you have physical disabilities?      and would you require special facilities?         

Have you ever been a patient in a mental hospital/sanatorium?
Yes   No   
If Yes,   Name of Hospital   Name of Doctor    Reason   

If Yes, explain briefly:      

If Yes,
Employers Address      
Employers Phone number   Area Code   Phone Number