Restore Lifestyle Coach Training Application

Application for 6th Batch Training to start in August 2024

Please complete without help from anyone.
Name*

Given NameFamily Name
What name would you like us to use for you?*
Address*

Street Address

City

StateCountry

Pin
Phone Number*

Country CodePhone Number
Whatsapp Number*

Area CodePhone Number
Email*
example@example.com
ALL our communication with you will be by EMAIL. Be sure to check regularly for messages from RestoreLCT.
Gender*

MaleFemale
Birth Date*

YearMonthDay
Date
Name of person who told you about this training? Please don't tell Auntie or Friend - give person's name.*
Please upload a RECENT photo of yourself*
Marital Status*

singlemarriedwidow/widowerseparated/divorced
Would any other family members come with you?

YesNo
Name, Relationship (spouse, child) and age*
Each person must complete a separate application
What denomination are you a member of?*
How long have you been a member?*
What are you currently doing?*

studentemployedlooking for something to doHousewifeRetired
Who is your employer?
What kind of work do you do?
What kind of work have you done in the past?
Where have you worked in the past?
Education Completed*

less than standard 12standard 12some college/universitycollege/university completed
Highest standard completed
How many years of college/university?
What is your degree in?
Where did you attend High School/College?
Why did you become a Christian?*
Tell me what Jesus means to you.*
What is your experience in telling others about Jesus?*
What have you done to teach other people about healthy living?*
Please explain what your health problems are.
How will these problems affect your ability to practice massage and hydrotherapy?
List the medications/drugs you are taking.
How often are you getting sick and missing school or work?*

MonthlyFew times in a yearMaybe once in a yearDon't get sick
Please explain what your food allergies are.
Do you struggle with depression?*

NeverSometimesOften
Please note

We do not provide treatment for students during the training. If you need health treatments please check the Restore Health Centre website for information.

www.restorehealthcentre.org
In the past I have used ...

tobaccodrugsalcoholnone of these
How many shots have you taken?

OneTwoMore than Two
You are not required to have covid shots to attend RLCT.
How many months?
What languages do you speak and read?*
What languages are you fluent in?*
What hands-on, practical skills do you have?*
Why do you want to take Lifestyle Coach Training?*
What do you want to do after you are finished the training?*
Please give the dates you will need to take leave and the reason.
Please give the names and contact information of 2 references (NOT FAMILY OR RELATIVES) that have known you for at least 2 years.
#1 Name*

First NameLast Name
Phone Number

Area CodePhone Number
Email*
example@example.com
What does this person do and how do you know them?*
# 2 Name*

First NameLast Name
Phone Number

Area CodePhone Number
Email*
example@example.com
What does this person do and how do you know them?*
You will be emailed a financial aid application, please complete it promptly.
Name of Person who helped you complete this application.
NOTE
Be sure to check your email regularly for messages from RestoreLCT. We will NOT Whatsapp you.
Thank you for your application.

Please be sure to click on SUBMIT again after reviewing.

Also submit after Captcha
You will be emailed a copy of your application, if you don't receive an email with a copy you must send the application again, because it didn't submit. Have a wonderful day.
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Application for 6th Batch Training to start in August 2024

Each person must complete a separate application