Application Form

Surname:

2021 STUDENT APPLICATION

CHRISTIAN LEADERSHIP DEVELOPMENT: DURATION 3 YEARS

Full Names:

Call Name:

Gender:

Birth Date:

Age:

Country of origin:

Town of Birth:

ID / Passport Number:

Note: Please upload a copy - see par 14

Passport Date of Issue:

Passport Expiry Date:

Passport Place of Issue:

Visa Expiry Date:

Asylum seeker?

1. PERSONAL PARTICULARS:

Cellphone Number:

Home Phone Number:

Email Address:

Postal Address:

Physical Address:

2. FAMILY CONTACT DETAILS: (Whom should we contact in case of an emergency?)

Spouse/Family Member
Name & Surname

Cellphone Number:

Email Address:

Postal Address::

Farther/Mother/Gaurdian
Name & Surname

Cellphone Number:

Email Address:

Postal Address::

3. HEALTH:

How is your health?

Please indicate the deseases you had during the past five years:

Are you suffering from any desease at present?

Do you suffer from any chronic diseases?

Do you suffer from any injuries?

Do you experience hearing loss?

Do you have any disabilities or special needs?

Please note that BBM does not make provision for any special diet.
Please upload a copy of a RECENT MEDICAL EXAMINATION REPORT - this you must get from a doctor with his/her telephone number after he/she examined you.

4. DRIVER’S LICENCE:

Do you have a South-African driving license?

Do you have a Code 10 South-African drivers license?

Do you have an international driving license?

5. ENGLISH LITERACY:

Ability to UNDERSTAND English

Ability to SPEAK English

Ability to READ English

Ability to WRITE English

6. COMPUTER SKILLS:

General Typing Skills

Internet & Email

Microsoft Word

Power Point

7. EDUCATION/QUALIFICATIONS:

Indicate ALL academic qualifications.

Post Secondary School Diploma

Post Secondary School Certificate

Secondary School: Grade 12 with SIX SUBJECTS

OTHER:

Last Educationsl Institution attended:
Telephone Number:

Please upload a certified copy of your ACADEMIC QUALIFICATIONS (See par 14 for uploading of files)

8. WORK EXPERIENCE:

Present Occupation:

Work Description:

Give details of any training you have had e.g. computers, painting, tiling, plumbing, electricity, carpentry, welding, etc:

9. FAMILY LIFE:

Who will care for your spouse/children while you are at BBM? Provide name, address and telephone number:

What is the view of your family (spouse/children/parents) towards your intention to come to BBM?

Are you prepared to live and work with other nationalities?

10. OTHER INTERESTS AND SKILLS:

List any other interests and skills you may have:

11. REFERENCES:

Load a copy of letters from three REFERENCES (compulsary) with telephone numbers:

Religious leader/pastor of the group you are presently attending
Present or previous employer or prinicipal of institution of education
A senior family member.

12. FINANCES:

Leadership Preparation at BBM is free of charge, but Boarding and Lodging cost R5000 per annum. A deposito/registration fee of R2000 must be paid on arrival or deposited in the bank before arrival. The bank account details are:
Account Name: Back to the Bible Mission
Bank Name: First National Bank
Branch: Barberton - Code: 270152
Account type: Cheque/Current
Account number: 51600018323
Swift code: FIRNZAJJXXX
The balance of R3000 must be paid by July. Please explain your financial support in writing. List names, addresses and telephone numbers of at least 3 sponsors who will pay for your Board and Lodging while staying at BBM. No unpaid money can be carried over to a following year,

13. UNDERTAKING:

I declare that all information provided by me on this form is true and correct and that I signed voluntary. By pressing the SUBMIT button below you agree to have signed this document.

14. DOCUMENTS TO BE UPLOADED:

Please select the documents to be sent with your application below. Remember to bring your original documents with you when coming to BBM.

ID document / Passport:

Marriage certificate (If husband and wife are both coming to BBM):

Medical examination report:

Study Permit (Compulsary for International students)

Short Life Story:

Academic Certificate:

Reference letters:

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