POLAND - RBTC Student Application

RBTC Student Application Form

Thank you for your interest in attending RBTC in Poland!
* Aby wypełnić wniosek w języku polskim, kliknij TUTAJ.
How did you hear about RHEMA?*

WebsiteSocial Media (Facebook, Instagram, etc...)RBTC Brochure/FlyerGoogle AdMy PastorAnother RHEMA GraduateSomeone came to my churchOther
We are a Bible School that helps you understand God’s Word so that you can move forward in God’s Plan for your life. We look forward to seeing how we can help you along in your journey of faith as we build the Church together.

Filling in and submitting this Student Application Form is your first step to become an RBTC Student.

The RBTC Student Application Form includes the following sections:
- Personal Details
- Church Affiliation
- Educational History
- Employment History
- Health Concerns
- Personal Testimony
- Personal Reference
- Late Application Fee
- Eligibility to Study (passport/residency information)
We encourage you to start your application process early to make sure everything can be processed in time for your desired intake. Your application will be processed once all of your supporting forms and payments are received in our office. This will include a Pastoral or Personal Reference. You are responsible for requesting a reference and following up with them. We provide more information about how you can do that in the corresponding section below.

Application Guidance
1. We recommend that you allow yourself about 30 minutes to complete the application form.
2. You can 'save' and come back to your form at any time.
3. You will move through the form quicker if you have some of the relevant information accessible, such as your passport/residency card.
4. On this form you are requested to share your personal testimony. Some applicants prefer to write this this in Word or Pages and then paste it into the form.
5. Please answer all applicable questions.
6. Use the digital signature pads to sign all forms.
Campus Name*
Campus Intake Date*
PERSONAL DETAILS
Name*

TitleFirst NameLast Name
Address*

Street Address

Street Address Line 2

CityZip/Postcode

State
Country*
Mobile Phone*

Country Code eg: 🇵🇱 +48 // 🇺🇸: +1Phone Number eg: 🇵🇱 123 456 789 // 🇺🇸: 123 123 4567
Email address *
example@example.com
Gender*
Date of Birth*

YearMonthDay
YYYY-MM-DD
Marital Status *
Nationality *
What is your primary language?*
What other languages are you comfortable in?
What language would you like to receive your school materials in? *

PolishEnglish
Are you Born-Again (saved) as understood in Romans 10:8-10?*

YesNo
Date of Salvation (As understood in Romans 10:8-10?)*

YearMonthDay
if unsure of exact date add the year and 01-01 (YYYY-MM-DD)
Are you baptized in the Holy Spirit with the evidence of speaking in tongues as in Acts 2:2-4?*

YesNo
Date you were baptised in the Holy Spirit?*

YearMonthDay
if unsure of exact date add the year and 01-01 (YYYY-MM-DD)
CHURCH AFFILIATION
Are you currently attending a local church? (Including attending church online)*

YesNo
Please explain why you are not currently attending a local church.
Please describe your regular attendance (incl. types of services and frequency).
When did you start attending this church?*

YearMonthDay
If you are unsure of the exact date, use “01-01” for the month and day.
Are you a member of your church?

YesNo
Church Name*
Church Denomination *
Church Address*

Street Address

Street Address Line 2

CityZip/Postcode

State
Country*
Church Phone Number*

Country Code eg: 🇵🇱 +48 // 🇺🇸: +1Phone Number eg: 🇵🇱 123 456 789 // 🇺🇸: 123 123 4567
Church Email Address*
example@example.com
Pastor's Name*

First NameLast Name
Pastor's Gender*
Are you a lead or supportive pastor/minister in your local church?*

YesNo
How do you serve in your local church?*
eg: Children's worker, Children Pastor, Usher, Greeter, Worship leader, Guitarist, Attendee
Please list any current or past church activities you have been involved in.*
EDUCATIONAL HISTORY
What is the highest level of eduction you have obtained? *
Please Specify
Please list schools that you have attended.*
Name of School, Dates, Major, Degree
EMPLOYMENT HISTORY
Please list two jobs and associated responsibilities, beginning with your present employer.*
Name of Employer, Position, Dates of Employment
HEALTH CONCERNS
Do you have any disabilities that would require special facilities?*

YesNo
If Yes, please explain:
PERSONAL TESTIMONY
Please share something with us about your Personal Testimony, such as when you were born again and ways you have grown in faith since then. You can include Scriptures that impacted your life, people who have helped you in that journey, or particular experiences. We are looking primarily for content, but your grammar and presentation should be your best. Your testimony should be no more than 400 words in length. If you need more time, you can save your application form, work on this offline, then come back and paste it into this field when you are ready.
Personal Testimony*
PERSONAL REFERENCE
All applicants must have a Reference on file. The Reference Form should be filled out by your designated Reference person privately, and submitted directly to RBTC Admissions. You may request this from anyone who is not a family member. We recommend your Pastor or another church leader, such as an associate pastor or small group leader. It may also be a mentor, professional, employer/supervisor, or co-worker. 

 Due to Privacy Regulations, you will need to ask someone to submit the reference form for you; we are not able to contact them on your behalf. You can copy the following link and text and email it to your reference person. Please request that they submit it to the RHEMA Polska office within 14 days of your application. Your application will not be complete until we receive this reference form. In the case that it is not submitted, we will let you know.
Email the below text to the person completing the reference form for you. You may personalize it.  

If you require a physical copy please contact our office or follow the link and print the reference form. Your reference person will be responsible for submitting the form back to the RHEMA Polska office within 14days.

Dear_________,

I have applied to RHEMA Bible Training College, Trójmiasto - Hybrid Studies Program.

My intended start date is 5 October 2024 and my application is not complete until I can provide a reference.

I would appreciate if you would be willing to complete the form and submit it on my behalf within 14 days of receiving this request. 

If you are unable complete this, please let me know as soon as possible so I can send this request to someone else.  https://form.jotform.com/221513700318848

Kind Regards,

Your name
I understand that requesting a reference is my responsibility. I have sent/will send the request to an appropriate person.
LATE APPLICATION FEE
Applications submitted after 1. August will have a non-refundable late application fee of 75 PLN
I am applying late (after 1. August 2024) and therefore required to pay a late fee:

YesNo
The non-refundable late fee can be paid in the following ways:

1. Bank Transfer:

Acct No.: 05 1240 1239 1111 0011 1350 7426

Bank Name: Bank Pekao S.A.

Recipient: Fundacja RHEMA Poland

Swift Code: PKOPPLPW

Notation: App Fee - Your Last Name

2. Paypal:

https://www.paypal.com/paypalme/rhemapolska

Notation: App Fee - Your Last Name
I will pay my late application fee by:

Electronic Banking TransferPaypal
PROOF OF ELIGIBILITY TO STUDY
RBTC (in Europe) does not qualify as an institution which can offer visa’s to students. Students must already be permitted to live and study in Poland to attend, or be able to travel into the country for school weekends.
Are you a Polish Citizen?*

YesNo
Do you already have a residency/visa that would allow you to live in Poland and study with RBTC?*

YesNo
Do you have a passport or EU Card that would allow you to travel into the nation for school weekends?*

YesNo
Your Application has been paused! Please secure permission to enter and study in the country before continuing to apply to RBTC. Please note that RBTC is not able to sponsor your visa or entry requirements. Save and exit the application. Please contact the office for any further information you may require: biuro@rhema.org.pl
Passport & Visa

Please attach a copy of your passport / National ID. If you do not have a Polish or EU passport, please also attach a copy of your visa or residence card.
Cancelof
Declaration*

I hereby state that all the information contained on this application is correct and true. If RHEMA Bible Training College is notified that any of the information contained on the application is false, it will be grounds for immediate dismissal.I understand that all information contained in this application will be kept as part of my permanent file, and might be shared with RBTC affiliates to include RHEMA USA and RHEMA Europe. I consent to the aforementioned statements and affix my signature.
Your Signature*

Clear
.
* I consent to the processing of my personal data by RHEMA Poland, ul. Bohaterów Getta Warszawskiego numer 7-9, 81-609 Gdynia (hereinafter: "Administrator"), for the purpose of using the contact form at www.rhema.org.pl . Provision of data is voluntary. The basis for data processing is my consent. Recipients of the data may be the Administrator. I have the right to withdraw my consent at any time. Personal data will be processed for the period necessary to respond or to revoke consent, and after such revocation, for the period of the statute of limitations for claims to and against the Administrator. I have the right to request from the Administrator access to my personal data, rectification, erasure or restriction of processing, as well as the right to lodge a complaint with a supervisory authority.
RBTC may request an interview with potential students as part of the application process.
Not everyone who applies to RBTC is accepted into the program.
If you have any questions, please email us at biuro@rhema.org.pl
Should be Empty:

RBTC Student Application Form

PERSONAL DETAILS

CHURCH AFFILIATION

EDUCATIONAL HISTORY

EMPLOYMENT HISTORY

HEALTH CONCERNS

PERSONAL TESTIMONY

PERSONAL REFERENCE

LATE APPLICATION FEE

PROOF OF ELIGIBILITY TO STUDY