RHEMA Bible Training Centre Zambia

EDUCATIONAL RECORD

Minimum Entry Qualification to RBTCZ is Grade 12 GCE.
Can you read, write, and comprehend the English language? *

Yes No
List Secondary / High School and / or Tertiary educational institutions attended: *
Are you currently employed?

Yes No Own a Business
Have you ever been denied acceptance or been suspended / expelled from RBTCZ or any educational institution?

Yes No Maybe

Church Affiliation and References
What church do you currently attend? *
Church Address  * Address Line *
Name of Pastor: First Name    Last Name
Pastor's Mobile No.   Phone Number
How long have you been attending this church? *
If less than a year,explain
What Church activities have you been involved in, and how long?
If you are not currently involved with a local church, explain why below.
Pastor/Minister Referee (Name, Tel., & Email) *
Enter their Full name, Telephone number and Email Address
Personal Referee (Name, Tel., & Email) *
Enter their Full name, Telephone number & Email Address
Employer (Work) Referee
Enter their Full name, Telephone & Email Address
Do you believe the Bible is the inspired Word of God and the only infallible guide in matters pertaining to conduct and doctrine? *

Yes No
Do you believe in the Holy Trinity – that our God is one, but manifested in three persons: the Father, the Son and the Holy Spirit? *

Yes No
Do you believe in the deity of the Lord Jesus Christ, that He is God made flesh, and He is the only mediator between God and man? *

Yes No

Health/Medical

If you have any disabilities that would require special facilities, please state what they would be. Also give the full name and address of a contact person in case of emergencies.
Disabilities/Medical Condition
Next of Kin:First Name* Last Name* Phone Number*
Street Address* Home Line* City* Province*

I, the undersigned, grant full and complete permission to Rhema Zambia, its employees or designates, or any related or consulting physician to render or give emergency medical aid, care, treatment, or assistance that could or would be deemed required or necessary. This consent I give freely and voluntarily, fully knowing and understanding all the above and its effect upon me. *

Yes No
I hereby state that all the information contained in this application is correct and true. If Rhema Zambia is notified that any of the information contained on the application is false, it will be grounds for immediate dismissal. *

Yes No
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EDUCATIONAL RECORD