restore+transform DTS Application

Hello from YWAM Ozarks!

Thanks for considering this beautiful location for your DTS. This form will guide you step by step through the application process.

Here’s what you will need in front of you in order to complete the application:
- Your pertinent information of address, phone number, & emergency contact.
- Name of your home church if you have one, and pastor’s name.
- Your passport, if you already have one.
- Places you went to school and approximate dates.
- Health Insurance Information
- $25 Registration Fee (Checks are payable to YWAM Ozarks)
At the end of this form, you will be given some more steps to complete the application process. As always, please let us know if you have any questions.

Youth With A Mission (YWAM) admits students of any race, color, national and ethnic origins to all the rights, privileges, programs and activities generally accorded or made available to students at the school. It does not discriminate on the basis of color, national and ethnic origin in administration of its educational policies, admission policies and school-administered program.
Write your full name acknowledging that you have read and understand the information provided above.

Personal Information
Full Name*

First NameMiddle NameLast Name
Birth Date*

MonthDayYear
Age*
Upload Recent Picture*

Upload a File

Cancelof
Present Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Permanent Address (if different from above)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail*
Phone Number*

Area CodePhone Number
Preferred contact method:

TextPhone CallEmail
Emergency Contact*

First NameLast Name
Emergency Contact Phone*

Area CodePhone Number
Emergency Contact Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Name of Home Church*
Length of Attendance*
Home Church Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Home Church Phone*

Area CodePhone Number
Home Church E-mail
Marital Status*

SingleEngagedMarriedDivorcedWidowedSeparated
Maiden Name

First NameLast Name
Spouse's Name

First NameLast Name
Anniversary

MonthDayYear
Please list the names, birth dates, and school grades of children accompanying you*
If your spouse and/or minor children do not live with you, please explain. At YWAM Ozarks we require that spouses come and do the DTS together. If one spouse has done DTS already, she/he is expected to be full-time staff unless the preference is to do DTS again.
* A nanny must accompany children under 5.
YWAM gives room for many expressions of faith, including justice, church planting, the arts, media, agriculture, family ministry, business, medicine, and much more.

Passport Information
City and Country of Birth*
Country of Citizenship*
Do you have a passport?*

YesNoIn Process
Passport Expiration Date

MonthDayYear
Full name as it appears on your passport

First NameLast Name
Birth date as it appears on your passport

MonthDayYear
Did you know that Arkansas is the number one rice and poultry producing state in America?

Educational History
Did you complete high school?

YesNo
Name of Secondary/High School or equivalent, from which you graduated/will graduate:
GED Certificate (approximate)

MonthDayYear
Location
Secondary School Start Date (approximate)

MonthDayYear
Secondary School End Date (approximate)

MonthDayYear
Name of College/University/Vocational School/Seminary Attended:
Location
Date of Graduation (past or future)(approximate)

MonthDayYear
Degree Type
Information on Additional Schools Attended
Please list your occupational skills and the years of experience in each area.
Please list any musical abilities or other talents that you have and the years of experience in each area.

Criminal Record
Have you ever been convicted of a felony?*

YesNo
If yes, please explain.
Date and Location of Conviction of Felony
Have you ever been convicted of a sexual crime?*

YesNo
If yes, please explain.
Date and Location of Conviction of Sexual Crime
Do you consent to a background check?*

YesNo
Did you know that YWAM Ozarks has a spiritual heritage dating back to the 1950s?

	Yes	No
Epilepsy
Mental/Nervous disorders
Chronic Fatigue
Asthma
Kidney disease
High blood pressure
Low blood pressure
Heart trouble
Back problems
Diabetes
Clinical Depression
Anorexia/Bulemia
Allergy: Food(specify below)
Allergy:Other* (specify below)

	Yes	No
Chicken Pox
Measles (Rubella)
Measles (Rubeola)
Mumps
Pertussis
Scarlet Fever
Tuberculosis
Other (specify below)

	Yes	No
Irregular periods
Severe cramps
Excessive flow
Are you pregnant?
Previous pregnancies

	Yes	No
Tuberculosis
Diabetes
Kidney disease
Heart disease
Arthritis
Asthma, Hay fever
Stomach disease
Epilepsy, convulsions
Cancer
Hypertension

Personal Information

Passport Information

Educational History

Criminal Record

Financial Support

Youth With A Mission, Ozarks

Confidential Health Form

restore+transform DTS Application