Student Application

STUDENT APPLICATION
Medical Missionary Evangelism Training Program

A non-refundable $50 application fee is to be submitted by applicants before the application will be processed.

For International Students: Check with your local US consulate to check appointment availability before proceeding with the application.

Please make sure that all the required questions are answered or this form may fail to be processed.

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I am applying for: *

Personal Info

Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Birthplace *

Citizenship *

Marriage Status *

Applicant Photo *

Max file size: 20MB

Phone Number *

Email *

Age *

Birthdate *

Gender *

HEIGHT *

WEIGHT *

Starting Date *

Emergency Contact

Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Relationship *

Phone Number *

Email *

Religious Info

Church Affiliation *

Home Church *

How long have you been a member? *

Christian Experience

Describe your Christian experience, including your home background, conversion experience, and your growth in Christ. *

Spirit of Prophecy

Are you familiar with the messenger of prophecy to the Seventh-Day Adventist Church? *

How do you regard her writings? *

How did you hear about Eden Valley? *

Training Interest

Why are you interested in training at Eden Valley? How did the Lord lead you to this decision? *

Goals

What are some of your long-term goals? *

Health

Do you have an illness or disease that would prevent you from taking on a full work/class load? *

If yes, then please explain: *

Education

School

High School *

College *

Other *

Course of Study

Course of Study *

Did you graduate?

Select One *

Dates Attended

from *

to *

Employment

Employer

Employer #1 *

Employer #2 *

Employer #3 *

Employer #4 *

Type of work

Type of work *

Dates employed

From *

To *

Reasons for leaving

Reason for leaving *

Experience, Skills & Trades

Please list any significant experience, skills or trades that you possess. *

Language Skills

How well do you read, write, and understand English? *

What languages do you speak fluently? *

References

Pastor

Name *

First

Last

Email *

Phone Number *

Employer

Name *

First

Last

Email *

Phone Number *

Friend

Name *

First

Last

Email *

Phone Number *

Submit