Application Form

Thank you for your interest in Better Living’s Media Missionary training program. You will need to fill out the following application as completely as possible. You will also need to have 3 reference forms completed and sent to us. Your application form is confidential.

First Name: *

Last Name: *

Home Phone *

Cell Phone:

E-mail: *

Video Interview Contact Info *

For example Skype Name, Gmail address for Google Hangouts or other.

Address: *

City: *

State/Province

Postal Code: *

Country: *

PERSONAL DETAILS

Birth Date: *

Citizenship: *

Native Language: *

Marital Status *

Married

Single

Divorced

Number of Children: (If applicable).

Age of Children: If applicable, please give the ages or age range of your children.

PASSPORT INFORMATION (For International Students Only)
Please supply a copy of the information page of your passport in addition to this information. Your passport must be valid for at least 2 years at the time you arrive at Better Living. You cannot apply for a VISA until Better Living approves your application. Contact your local Canadian embassy or consulate to complete the VISA process.

Passport Number:

Country Issued:

Expiration Date:

CANADIAN RESIDENCE (For Non-Canadian Citizens Only)

If you are not a Canadian citizen but are living in Canada, please indicate your VISA status.

Permnent Resident Card Number:

EDUCATION EXPERIENCE
List the schools you have previously attended (starting with the most recent). If homeschooled, please indicate.

School #1: *

City & Country of Institution: *

Years Attended: *

Level Completed: *

School #2:

City & Country of Institution:

Years Attended:

Level Completed:

School #3:

City & Country of Institution:

Years Attended:

Level Completed:

Have you ever been dismissed from an educational institution? *

No

Yes

If Yes, please explain why.

WORK EXPERIENCE
List your most recent work experience. If you have not had official employment, please indicate volunteer or other projects that may be considered work.

Job #1: *

Years Worked: *

Position & Experience Gained: *

Job #2:

Years Worked:

Position & Experience Gained:

Job #3:

Years Worked:

Position & Experience Gained:

List any previous experience in media and technology

List any previous missionary involvement

HOW FLUENT ARE YOU IN THESE LANGUAGES?
How well can you understand and communicate in these languages? Please check all that apply.

English: Listening *

English: Reading *

English: Writing *

English: Speaking *

French: Listening *

French: Reading *

French: Writing *

French: Speaking *

Other Language(s): Please indicate if you know any other languages, and how well you can listen, read, write, and speak in those languages.

MEDICAL

What is your typical diet? *

Vegan

Lacto-Ovo Vegetarian

Non-Vegetarian

Do you have any allergies (food, environment, etc)? *

Yes

No

If Yes, Please Specify *

Do you have any physical, mental or medical impairment or disability that would impact your daily life at Better Living? *

Yes

No

If Yes, Please Specify

Have you used any alcohol, tobacco, or any mind-altering drugs during the past two years? *

yes

No

I understand and accept that all medical and dental costs or insurances are to be arranged and covered by myself prior to starting the Media Missionary program at Better Living. *

Yes

No

Emergency Contact

Emergency Contact #1 *

Relation: *

Phone Number: *

Secondary Phone Number:

E-mail:

Emergency Contact #2:

Relation:

Phone Number:

Secondary Phone Number:

E-mail:

CHURCH AFFILIATION

Please describe in your own words your Christian experience, your own background, your conversion, your growth in Christ and your personal relationship with God. *

Are you a baptized member of the Seventh-day Adventist Church? *

No

yes

If Yes, please indicate how long you have been a member in number of years.

Do you understand and agree with the fundamental beliefs and practices of the Seventh-day Adventist Church? *

Yes

No

If there are beliefs that you do not agree with, please explain why.

Name of your Local Church: *

Phone Number: *

Pastor's Name: *

Pastor's Phone Number: *

REFERENCES
Please ask the persons you have typed below to fill in a Reference Form. These persons should know you well, but at the same time they need to be able to communicate sufficiently in English or French. Please give one reference from each category.

Person #1 : *

Relation (pastor, elder, family, friend, teacher, employer...) *

Phone/E-mail *

Person #2 : *

Relation (pastor, elder, family, friend, teacher, employer...)) *

Phone/E-mail *

Person #3 : *

Relation (pastor, elder, family, friend, teacher, employer...) *

Phone/E-mail *

PROGRAM GOALS

What is your main objective in joining the Media Missionary program? *

What do you believe you can contribute within a media ministry? *

How did you hear about the program? *

FUTURE PERSPECTIVE

What do you plan to do when you finish our program? *

FINANCES
The Better Living Media Missionary training program is a tuition-free program. Living accommodation will be arranged for the student. However, the student is responsible to pay for the room, board, and any other personal needs during their stay for the training program.

I understand that I will need to cover the cost of room and board and any other personal needs during the training program. Room and board is $600 CAD ($450 USD) per month. *

Yes

No

COMMITMENT

Travel Expense: I understand that I am responsible for financing my own travel to and from Better Living, pocket money for the year, as well as taking care of my medical insurance. *

Agree

Disagree

Christian Conduct: I agree to abide by the principles of Christian conduct. *

Agree

Disagree

Signature of Applicant: *

Date :