wbh application student

1
Do you apply for the full Word-by-Heart School or a seminar week?* This field is required.Please choose one option.
three-month school
a seminar week
2
Which seminar weeks do you want to join?* This field is required.Please choose one option.
April 28 - May 2
June 9 - 13
June 16 - 20
3
name* This field is required.
First Name
Middle Name
Last Name
4
Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
5
Email* This field is required.
example@example.com
Confirm Email
6
Nationality* This field is required.
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Phone Number
Country Code
Area Code
Phone Number
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Passport Number* This field is required.
9
Expiration Date on Passport* This field is required.
Date
Year
Month
Day
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Date of Birth* This field is required.
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Marital Status* This field is required.
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If you are married or have children that will join you, kindly include the names of your spouse and children.
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Ok
13
Did you do a DTS? If so, when and where?* This field is required.
14
What kind of degree do you have?* This field is required.Example: Highschool, Bachelor, College...
15
Please let us know what you did in the past ten years?* This field is required.Example: 2015 DTS and DBS 2016 - 2020 job training/Bachelor 2020 - 2024 Job title
16
Do you have more YWAM experience? Please let us know.* This field is required.
17
What church/denomination do you currently join?* This field is required.
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Since when do you see yourself as new born Christian?* This field is required.
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How would you describe your current relationship with Jesus?* This field is required.
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Do you have any food intolerances or need a special diet? * This field is required.
21
Are there any diseases we should be aware of? (allergies, infectious disease, HIV, diabetes, depression, anxieties, ...) Do you or did you suffer from any eating disorder? * This field is required.
22
Do you need to take medication regularly? If yes, what kind?* This field is required.
23
Have you ever participated in drug or alcohol abuse?* This field is required.
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Contact person in case of an emergency* This field is required.
First Name
Last Name
25
their phone * This field is required.
Area Code
Phone Number
26
their Email* This field is required.
example@example.com
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Relationship* This field is required. In what relationship are you standing with that person.
28
How do you plan to pay the Word By Heart School fees?* This field is required.
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Do you have debts?* This field is required.
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Mothertongue* This field is required.
31
Other languages* This field is required.Do you speak other languages? How well do you speak them? (fluently/good/basic)
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Musical talents* This field is required.Do you sing or play an instrument? Would you join in worship with it?
33
Other talents* This field is required. creative, cooking, backing, practical,...
34
Do you think you are an adaptable person?* This field is required.
YESNO
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Do you see yourself as...* This field is required.Multiple answers possible
confident
ambitious
honest
curious
loyal
courageous
calm
affectionate
patient
active
open
creative
clever
affectionate
articulate
36
What weakness do you have?* This field is required.
37
Describe your communication style* This field is required.Please tick a box in each line that best applies to you.
Communicate emotionally
Communicate factually
Share problems
Need to be asked
Able to socialize easily
Quietly withdrawn
38
Please categorize yourself in the following areas.* This field is required.Tick the box that best applies to you. (A = very strong to F = very little)
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Responsibility
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Positive attitude
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Flexibility
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Ability to work in a team
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Willingness to serve
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Willingness to learn/teachability
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Leadership Potential/servant leadership
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Ability to deal with conflict - willingness to address & clarify issues
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Willingness to forgive
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Time management
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Self-organization
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Perfectionism
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Emotional balance
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Self-care
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Health
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Responsibility
Punctuality
Dealing with finances
Positive attitude
Taking initiative
Relating to other people
Flexibility
Ability to work in a team
Willingness to serve
Willingness to learn/teachability
Leadership Potential/servant leadership
Ability to deal with conflict - willingness to address & clarify issues
Willingness to forgive
Time management
Self-organization
Perfectionism
Emotional balance
Self-care
Health
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39
Where did you hear about Word By Heart?* This field is required.
40
What are your expectations for the Word By Heart School/the seminar week?* This field is required.
41
Do you have experience with Word by Heart? If so, which? (e.g. was part of a WbH seminar, heard a WbH presentation,...)
42
Please let us know who you would ask to fill out your recommendations.* This field is required.Please type in their names. They find the reference letter on our website next to the application button. (https://www.ywamaltensteig.org/word-by-heart-verlinkung)
43
I, the above named applicant, waive any right I have to read or obtain copies of these reference forms, knowing that this waiver is not required as a condition for admission.* This field is required. Please sign here.
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44
Insurance and medical authorization

I herewith agree today to receiving medical treatment in the case of illness or injury. I authorize the responsible YWAM leader to supervise and administer first aid in the case of minor injuries. Provided that a doctor recognized by the government agrees, I may be hospitalized and appropriately treated (including injections, anesthesia, an operation or other justifiable measures

I assume responsibility for the complete costs of such treatment. As far as possible, my health insurance company will accept responsibility for such costs. As well as this I authorize the disclosure of medical information to my insurance company for the purpose of them testing the validity of the claim being made.

I am aware that I myself am responsible for all medical or other costs involved with this activity.

I confirm that I am physically able to take part in these activities.
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Place* This field is required.
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Date* This field is required.
Date
Year
Month
Day
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Signature* This field is required.
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48
Electronic storage of pictures and personal information

I hereby allow the electronic storage of personal information (performed in the legal manner) and pictures that have been attained during the school and used for the organization of Word by Heart as well as for internal purposes. This includes the use of pictures for the newsletter and website of JMEM.
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I ...that this information be passed on to the "Jugend mit einer Mission Deutschlandverband e.V" (YWAM-Germany) and their encompassed works.* This field is required.
I agree...
I agree only in ananymous form...
I don't agree...
50
Place* This field is required.
51
Date* This field is required.
Date
Year
Month
Day
52
Signature* This field is required.
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53
General rights - place of jurisdiction

I am aware that the sending body JMEM is an in Germany domiciled and registered association. In case of any legal dispute the basis for this dispute in terms of rights, duties and compensations is the German law. Any legal disputes have to be settled at that place where the sending JMEM Altensteig has its domicile.
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Place* This field is required.
55
Date* This field is required.
Date
Year
Month
Day
56
Signature* This field is required.
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57
Please upload a picture of yourself.
Drag and drop files here
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58
You are also required to pay a application fee of 50€ which should be payed through the YWAM Altensteig website or a bank transfer. With my name I confirm that my information is correct.Your name
59
Please verify that you are human* This field is required.
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