• 2nd Year Application Form

    RHEMA Bible Training Centre Zambia
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    Pick a Date
  • MARITAL STATUS

  • Personal Data of Spouse/Fiancé(e)  
               
    Marriage Details
    Date of Legal Marriage:   Pick a Date   
                   
    Have you been married before?       
    If yes;
    How many time's   
    Date of last marriage      
    Date(s) of Divorce(s)      
    Number of Children from previous marriage      

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

    Spouse's Spiritual Details
    Is your spouse born again?      
    Will your spouse be attending RBTCZ?      
    Has your spouse previously attended RBTCZ?      
     If Yes, which year?      
    Did your spouse graduate?      
    Is your spouse in agreement that you attend RBTCZ?      
    If No, explain why      
    Will your spouse (and your dependent family) be residents with you while you attend RBTCZ?      
    (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?         

    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            

  • Medical Data

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  • 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?
    * 
    If Yes,            

  • Medical Consent: “I hereby grant permission to RBTCZ or a consulting physician to render to me any emergency treatment or medical care that might be deemed necessary. When necessary for executing such care, I grant permission for hospitalisation at an accredited hospital. This healthcare will be covered at my own cost. I will not hold RBTCZ liable for any expense occurred.

  • Spiritual Details

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    If Yes, explain briefly:      

  • EDUCATIONAL RECORD

    Minimum Entry Qualification to RBTCZ is Grade 12 GCE.
  • Occupation Details

  • If Yes,
    Employers Address     
    Employers Phone number         

  • Financial & Legal Facts

    Zambian applicants should quote these figures in Zambian Kwacha. International applicants must quote all financial figures in US Dollars

  • Church Affiliation and References

  • Church Address  * *  
    Name of Pastor:          
    Pastor's Mobile No.     

  • Declarations

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  • APPLICANT'S DECLARATION:   "I understand that course of study at RBTCZ is a two-year program. In order for me to obtain a certificate or Diploma I must comply with the attendance and academic requirements for the entire year of study.”

  • 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.
  • Next of Kin:*   *  * 
    *   *   *   *   

  • Accompany Application Documents

  • Should be Empty: