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One Day Retreat
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STUDENT APPLICATION
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I am applying for:
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Medical Missionary Program
Starting Date
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Select a date
July 2 - November 21, 2021
Personal Info
Name
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First
Last
Address
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City
State
Zip Code
Country
Birthplace
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Citizenship
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Marriage Status
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single
married
divorced
separated
widow/widower
Applicant Photo
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Phone Number
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Email
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Age
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Birthdate
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Weight
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Height
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Gender
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Emergency Contact
Name
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First
Last
Address
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City
State
Zip Code
Country
Relationship
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Phone Number
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Email
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Religious Info
Church Affiliation
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Home Church
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Please include city and state.
How long have you been a member?
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Christian Experience
Describe your Christian experience, including your home background, conversion experience, and your growth in Christ.
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Spirit of Prophecy
Are you familiar with the messenger of prophecy to the Seventh-Day Adventist Church?
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Yes
No
How do you regard her writings?
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How did you hear about Eden Valley?
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Training Interest
Why are you interested in training at Eden Valley? How did the Lord lead you to this decision?
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Goals
What are some of your long-term goals?
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Health
Do you have an illness or disease that would prevent you from taking on a full work/class load?
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yes
no
If yes, then please explain:
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Education
School
High School
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College
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Other
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Course of Study
Course of Study
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Course of Study
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Course of Study
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Did you graduate?
Select One
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yes
no
Select One
*
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No
Select One
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yes
no
Dates Attended
from
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month/year
from
*
month/year
from
*
month/year
to
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month/year
to
*
month/year
to
*
month/year
Employment
Employer
Employer #1
*
Employer #2
*
Employer #3
*
Employer #4
*
Type of work
Type of work
*
Type of work
*
Type of work
*
Type of work
*
Dates employed
From
*
month/year
From
*
month/year
From
*
month/year
From
*
month/year
To
*
month/year
To
*
month/year
To
*
month/year
To
*
month/year
Reasons for leaving
Reason for leaving
*
Reason for leaving
*
Reason for leaving
*
Reason for leaving
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Language Skills
What languages do you speak fluently?
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How well do you read, write, and understand English?
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Experience, Skills & Trades
Please list any significant experience, skills or trades that you possess.
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References
Pastor
Name
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First
Last
Email
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Phone Number
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Employer
Name
*
First
Last
Email
*
Phone Number
*
Friend
Name
*
First
Last
Email
*
Phone Number
*
Submit
HOME
ABOUT US
2021 Convention
LIFESTYLE
Success Stories
Lifestyle Program
One Day Retreat
Program Dates
Rates and Payment
Follow-Up Form
Application Form
COVID-19 Protocol
EDUCATION
Medical Missionary / Evangelism
COUNTRY STORE
CONTACT
FARM
Farm Store
MEDIA
Photo Gallery
2017 Convention
2018 Convention
Faith Ventures
Volunteer Opportunities
FORMS
Volunteer Application
Student Application
Reference Form
DONATE
Volunteer Application