Enrollment Application / Registration
Missions Ablaze
PERSONAL INFORMATION
Title - Mark where appropriate
Mr
Miss
Mrs
Other
Name
First Name
Surname
Date of Birth
-
Month
-
Day
Year
Date
Age
Country of Birth
Are you a South African Citizen
Yes
No
ID Number
Cell Phone Number
Please enter a valid phone number.
Work Number
Please enter a valid phone number.
Email Address
example@example.com
Physical / Residential Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Postal Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Marital Status
Never Married
Married
Widowed
Divorced
Spouse's name (if applicable)
First Name
Surname
Phone Number (if Applicable)
Please enter a valid phone number.
ACADEMIC INFORMATION
Education Level (standard passed)
Please Select
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
Grade 7
Grade 8
Grade 9
Grade 10
Grade 11
Grade 12
Name of School or Institution
Date completed
-
Month
-
Day
Year
Date
Subjects passed
Post-Secondary Education (give details if applicable)
Bible School or other spiritual courses done (specify)
Where (if applicable)
Period of training & dates
EMPLOYMENT DETAILS
Are you in full-time employment?
Yes
No
Years of service (if applicable)
Name of Employer
Address of company you work for
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Were you ever involved in ministry work? (give details if applicable)
SPIRITUAL
Name of your church
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Name of your Pastor
Pastors Phone Number
Please enter a valid phone number.
May we contact him/her if necessary
Yes
No
Church Denomination
Charismatic
Pentecostal
Evangelical
Protestant
Roman Catholic
Other
Are you a born again Christian?
Yes
No
Date Born Again
-
Month
-
Day
Year
Date
Date Baptized
-
Month
-
Day
Year
Date
Describe your level of spiritual maturity
Give a short description of your expectations and your reason for coming to Missions Ablaze:
What is your vision/long term goal?
Where do you see yourself in one year from now?
Where do you see yourself in three years from now?
Where do you see yourself in five years from now?
Tell us about yourself. (include a photograph if possible)
HEALTH
Are you medically fit?
Yes
No
Have you had any serious illnesses?
Yes
No
Do you currently take any medication?
Yes
No
Your state of health?
Poor
Fair
Good
Rate your ability to engage and partake in physical working activity
Poor
Fair
Good
Have you ever been involved or suffered from any of the following:
Occult practices
Yes
No
Drug or alcohol addiction
Yes
No
Do you smoke cigarettes
Yes
No
Homosexual or lesbian activity
Yes
No
Mental illness or depression
Yes
No
Do you drink alcoholic beverages
Yes
No
Any other information you want to disclose regarding your health (details if any
MISCELLANEOUS INFORMATION
Do you have any hobbies, special interests or skills? (give details)
How long do you plan to stay at Missions Ablaze?
3 Months
6 Months
12 Months
Longer
Where did you hear about Missions Abalze?
Do you want to enroll for the Bible School programme? (full year course only—starts February)
Yes
No
How will you be supported financially during your stay at MISSIONS ABLAZE?
AGREEMENT - Applicant under 21 years of age
Agreement entered into by Missions Ablaze and the student/missionary and/or his/her parent(s) or guardian:- I, (applicant) declare, undertake and agree to the following: To abide by the rules and regulations of MISSIONS ABLAZE. To acquaint myself with the rules and regulations of MISSIONS ABLAZE and ABLAZE BIBLE SCHOOL as well as the changes thereto, which might be applicable to any courses I may be entering. I agree to follow the decision of the leadership on the full schedule of the programme(s) for any of the courses. To pay in full all monies due for course fees for any year of enrollment for any course at ABLAZE BIBLE SCHOOL. I exempt MISSIONS ABLAZE from all claims for compensation which may occur during my period of stay. That I am (A) capable to enter this agreement without assistance. (B) That I enter this agreement with the consent of my parents/guardian/spouse. (Delete A or B, whichever is not applicable)
Parent/Guardian/Spouse
First Name
Surname
ID Number (Parent/Guardian/Spouse)
Please note: By clicking submit you agree to all the agreements and T&C's of Missions Ablaze.
Submit
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