Student Application for Admission

StudentApplicationforAdmission
PersonalInformation(PleasePrintNeatly)
LegalName:___________________________________________________________________________________________________
Last First/Middle PreferredFirstName
Address____________________________________________________________________________________________________________
Street City Province
PostalCode
Country_________________________________________________________Phone(______)__________________________________
Age______________Birthdate___________________________PresentOccupation____________________________________
Haveyoueverbeenconvictedofacrime? ________Yes________No
Ifyes,pleaseexplain_________________________________________________________________________________________________
EmergencyInformation(Father/MotherorGuardian)
Name
Address
HomePhone:
WorkPhone:
CellPhone:
Email:
RelationshipGuidelines
Master’s Commission Edmonton has a no dating policy for the entire year of training. These guidelines
are to protect and strengthen the students’ relationship with the Lord and to protect their integrity as
disciples.PleasereadtheRelationshipGuidelinesintheStudentHandbook.
1.Areyoupresentlydatingorromanticallyinterestedinsomeone? _____Yes_____No
2.IhavereadtheRelationshipGuidelinesintheStudentHandbook. _____Yes_____NoInitial:_____
3.Iagreetothenodatingpolicyforthedurationof
Master’sCommissionEdmontonprogram:
_____Yes_____NoInitial:_____
PaymentDescriptionandDueDates
Fee
Application
Tuition#1
Tuition#2
Tuition#3
DescriptionandDueDate
Theamountisdueuponsubmittingthis
applicationandisnon‐refundable.
Due:PriortoJuly31,2015.Thisamountisnon‐
refundableandallocatedtopurchasingthe
resourcesfortheyear.Ifyouwouldprefer
availabletextbooksviaAmazonKindle,please
providetheemailaddressforyourAmazon
account.
Due:PriortoOrientation.Studentswhobringa
vehicleforcarpoolpurposesmayreceiveuptoa
$500.00deductionfromtheprogramfee.Please
seeStudentHandbookformoredetails.
Due:UponreturnfromChristmasBreak
TotalTuition
Cost
$100
$600
$4000
$600
$5300
Pleasecontactourofficeregardingquestionsaboutpaymentplansandoptions.
BringYourOwnDeviceInformation
Master’s Commission Edmonton will be providing iPads to students for note taking and book reading
purposes. Students who have either a tablet or laptop they would prefer to use must meet specific
requirements.StudentsprovidingtheirowndevicemayreceiveacredittotheirTuition.Devicesmustbe
abletoreadandeditPDFfiles,openKindlebooksandsendemails.
Wouldyouliketobringyourowndevice?_____No_____YesIfyes,whattypeofdevice?___________________
DoyouhaveagshareAccount?_____No_____YesIfyes,emailaddressofaccount?___________________
VehicleInformation
Doyouhaveyourdriver’slicense?_____Yes______No IfYes,whatclassoflicense?________________________
Areyouinterestedinbringingavehicleforcarpoolpurposes?_____Yes_____No
Make:_________________________________________Model:____________________________________Year:____________________
NumberofWorkingSeatbelts:______________________VehicleLiability($2million)_____Yes______No
Iunderstandthatifmyvehicleisnotselectedforthepurposesofcarpool,Iwillnotbereceivingthe
creditfortuitioncosts.Ialsounderstandthatitwillbemyresponsibilitytokeepmyvehicleinworking
orderthroughouttheyear. Initial:______________
FinancialResources
Listofdebts,loans,orpaymentsthatyoupresentlyhave:_______________________________________________________
_________________________________________________________________________________________________________________________
Presenttotalindebtedness$______________________________________MonthlyPayment$__________________________
WillyourdebtsbepaidoffbythestartofMaster’sCommissionEdmonton? _____Yes
_____No
Willyouhavethetotalamountoftheprogram’scostsbytherequireddates? _____Yes
_____No
Ifno,whatisyourplantopaytheoverallcostofMaster’sCommissionEdmonton?_________________________
________________________________________________________________________________________________________________________
PleasesignbelowthatyouhavereadandagreetothetermsoftheFinancialInformationintheStudent
Handbook.
SignatureofApplicant
Date
SignatureofParentorGuardian(ifstudentisaminor) Date
AcademicBackground
HighSchoolAttended_____________________________________________City_________________________Province________
GraduationDate_______________________________ordateofGEDcompletion_______________________________________
Below,pleaselistanyothercolleges,universitiesorschoolsyouhaveattended.
Academic Institution Location Dates Attended Diploma/Degree Earned Health
Doyouhaveanyphysicallimitation(s),learningdisability(s)orpre‐existingmedicalcondition(s)?
_____Yes_____No
Pleasedescribe_______________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
Areyoucurrentlytakinganymedication?
_____Yes
_____No
Pleasedescribe_______________________________________________________________________________________________________
Haveyoueverstruggledwithorbeentreatedforamentaldisorder(anxiety,depression,bipolar,eating
disorder,etc.)?
______Yes
______No
(Ifso,pleaseprovidemoredetailsonaseparatesheetofpaperincludingdescriptionofdisorder,any
medicationtakenandwhetheryouarecurrentlytakingthesemedications).
Describeyourgeneralhealth/Doyouhaveanyallergies?_______________________________________________________
Haveyoueverusedillegaldrugs? _____Yes
_____No
Ifyes,dateoflastuse:______________________
Doyousmoketobacco?
_____Yes
_____No
Ifyes,dateoflastuse:______________________
Doyoudrinkalcohol?
_____Yes
_____No
Ifyes,dateoflastuse:______________________
ReligiousInformation
HomeChurch
MailingAddress
Pastor______________________________________________________Phone__________________________________________________
Address
WhendidyouacceptChristasyourSavior?_______________________________________________________________________
Below,pleaseindicatewhatkindsofChristianserviceyouhaveparticipatedin.
Check HowLong?
Check HowLong?
Preaching
____
__________________________
WorshipLeading
____ ________________________
Youth ____
__________________________
VocalGroup ____ ________________________
Children’sWork
____
__________________________
Piano ____ ________________________
MissionaryWork
____
__________________________
StringedInstruments____ ________________________
Evangelism ____
__________________________
Other(Specify)
Other(Specify)
____
__________________________
____ ________________________
PleasereadtheFortRoadVictoryChurchStatementofFaithonthechurchwebsite(www.frvc.ca)
andrespondtothefollowingquestions:
Insofarasyouhaveformedanopinion,doyoufindyourselfingeneralagreementwithourStatementof
Faith?_________________________________________________________________________________________________________________
Arethereanyareasofdisagreement?______________________Ifso,pleasestatewhich___________________________
I promise that, if accepted to Master’s Commission Edmonton, I will at all times conduct myself as a
Christian,faithfullyanddiligentlyapplymyselftothestudiesrequiredbytheprogram,promptlymeetall
financial and other obligations, and carefully obey the rules and regulations as set forth by Fort Road
VictoryChurchleadershipandtheleadershipofMaster’sCommissionEdmonton.
Signature_____________________________________________________________________________Date_________________________
PastoralReference
NameofApplicant
Last (tobecompletedbyyourcurrentpastor)
First
Middle
TotheApplicant:Printyournameonthelineaboveandgivethisformtoyourpastor.Ifyour
father/motherisyourpastor,pleaserefertheformtoanotherministerorleaderinyourchurch.Ifa
personotherthanyourpastororassistantpastorcompletestheform,anexplanationfromyoushouldbe
senttothedirectorsofMaster’sCommissionEdmonton.
TothePastor:EachapplicantforadmissiontoMaster’sCommissionEdmontonmustsubmita
recommendationfromhisorherpastororsubstituteasmentionedabove.Seriousconsiderationisgiven
totherecommendation,and,thereforewerequestthatyoucompletetheformcarefullyandcandidly.
Becauseweexpectstraightforwardcomments,wewillhandlethisrecommendationwiththestrictest
confidence.
Followingtobecompletedbythepastor:
1. Howlonghaveyouknowntheapplicant?______________________________________________________________
Howlonghashe/shebeeninyourchurch?____________________________________________________________
2. Howwelldoyouknowhim/her?(checkonthefollowingscale)
_____Casually–justbynameandsight
_____Havehadfewpersonalcontacts
_____Fairlywell–havehadanumberofpersonalcontacts
_____Havehadaveryclosepastoralrelationship
3. Tothebestofyourknowledge,hastheapplicantmadeapersonalcommitmenttoJesusChrist?
_____Yes____No_____Idon’tknow
Comments____________________________________________________________________________________________________
_________________________________________________________________________________________________________________
4. Towhatextentistheapplicantengagedintheactivitiesofyourchurch(checkone):
_____Isirregularinattendance–littleinterestinactivities
_____Seldomparticipatesinactivities,althoughregularlyattends
_____Iscooperativeandusuallywillingtohelpinthevariousactivitiesofthechurch
_____Enthusiasticallyengagesintheactivitiesforhis/herage
5. InwhatformsofChristianservicehastheapplicantbeenregularlyactive(SundaySchool,Youth
Group,Choir,Outreach,etc.
6. Iftheapplicantdoesnotparticipate,doyouknowwhy?
7. Incomparisonwithotheryoungpeopleyouknow,howwouldyouratethispersoninthe
followingareas:
Superior Above Average Average Below Average Leadership Responsibility Loyalty to Church Commitment 8. Inyouropinion,doesthisapplicantpossessanyoutstandingabilities?________________________________
Pleasedescribe:______________________________________________________________________________________________
9. Inyourestimation,thisapplicant’sspiritualinfluenceonhis/herclassmateswillbe…
(pleasecircleone)
Strengthening
Neutral
Adverse
Idon’tknow
10. Pleasecirclethetermswhichbestdescribetheapplicant’sattitudetowardthechurch:
Warmhearted Devoted
Enthusiastic Critical
Contemptuous
Apathetic Sympathetic Bitter Tolerant
Respectful
Rebellious
Antagonistic Loving
Passive
Grateful
Other:___________________________________________________________________________________________________________
11. Wouldyouplacefullconfidenceinhis/herintegrity?
___________________________________________________________________________________________________
Comments:_________________________________________________________________________________________________
12. Toyourknowledge,doestheapplicantsmoke,drink,orhavetheyabuseddrugs?_________________
13. Aretherepersonalitytraits,whichhinderthisapplicantinhis/herrelationshipwithothers?______
______________________________________________________________________________________________________________
14. Pleasedescribehomefactorsofwhichyouareaware,whichmightaffecttheapplicant’ssuccessat
Master’sCommissionEdmonton.Weareinterestedinthepositiveaswellasthenegativefactors.
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
15. Hastheapplicantdiscussedwithyoutheconceptofadiscipleshipprogram?_____Yes_____No
DoyoufullyapproveoftheapplicantcomingtoMaster’sCommissionEdmonton?_____Yes_____No
Comments____________________________________________________________________________________________________
_________________________________________________________________________________________________________________
Signature______________________________________________Date__________________________
PrintName___________________________________________________________________________________________________________
Last
First Middle
Position__________________________________________________Phone(_________)_________________________________________
ChurchName_________________________________________________________________________________________________________
Address_______________________________________________________________________________________________________________
MailingInstructions
Pleasemail/faxthisformto:
Master’sCommissionEdmonton
13470FortRd.NW
Edmonton,ABT5A1C5
Fax:(780)472‐1383
Questions?Call780‐475‐1647
ParentalorGuardianReference
(tobefilledoutifthestudentis18orunder).
NameofApplicant
Last First
Middle
Instructions:ThepersonnamedaboveisapplyingforadmissiontoMaster’sCommissionEdmonton.
Wesupporttheauthorityofparentsinstudents’lives,anddesireyourcooperationincompletingthis
form.Allinformationwillbeheldinstrictconfidence.Yourreference,alongwithotherrequired
references,willhelpusinourdecisionastowhethertoacceptthisstudent’sapplicationornot
FamilyInformation
1. Mr.___________________________________________________Mrs.___________________________________________________
2. Whatrelationshipdoesthatapplicanthavetoyou?_____Son
_____Daughter
_____Other
Ifother,pleaseexplainrelationship________________________________________________________________________
_________________________________________________________________________________________________________________
3. Hastheapplicantdiscussedorconsultedwithyouconcerninghis/herinterestinattending
Master’sCommission?______Yes
_____No
4. Hastheapplicanthadanyseriousproblemsinsubmittingtoparentalorotherauthority?
_____Yes _____No
Comments____________________________________________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
5. WhatdoyouunderstandtobethemotivefortheapplicantwantingtoattendMaster’s
CommissionEdmonton?_____________________________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
6. HastheapplicantreadthroughanddiscussedwithyoutheguidelinesfortheiryearofMaster’s
CommissionEdmonton?_____Yes _____No
7. Whatwashis/hergeneralattitudetotheseguidelines?_________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
8. Understandingourdesirethattherebenoconflictwithparentalauthority,wouldyoube
supportiveoftheseguidelines?
_____Yes
_____No
Comments____________________________________________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
ReligiousInformation
Churchpresentlyattending_________________________________________________________________________________________
Pastor’sName___________________________________________________Phone(_______)___________________________________
Address_______________________________________________________________________________________________________________
Approval
DoyoufullyapproveoftheapplicantcomingtoMaster’sCommissionEdmonton?
_____Yes_____No
Pleasefeelfreetoaddfurthercomments__________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
Signature___________________________________________Date_____________________________
MailingInstructions
Pleasemail/faxthisformto:
Master’sCommissionEdmonton
13470FortRd.NW
Edmonton,ABT5A1C5
Fax:(780)472‐1383
Questions?Call780‐475‐1647
Mentor’sReference
(tobefilledoutbyyouth/youngadultleader,teacher,counselor,etc.)
NameofApplicant
Last First
Middle
ThepersonalnamedaboveisapplyingforadmissiontoMaster’sCommissionEdmonton.Your
cooperationincompletingthisMentor’sReferenceformwillbegreatlyappreciated.Allinformationwill
beheldinstrictconfidence.
Pleasecheckthefollowing:
Superior Above Average Average Below Average Inferior Academic Ability Initiative/ Motivation Concern for Others Leadership Ability Social Appearance Personal Appearance Moral Standards Cooperation/ Submission Reliability Response to Correction 1. Doyoubelievetheapplicantisaborn‐againChristian?_____________Whatevidencehaveyouseen
inhis/herdailylife?_________________________________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
2. InwhatformofChristianworkhastheapplicantengaged,andwithwhatsuccess?Giveafull
statementaspossible.
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
3. Commentonthefamilyandsocialbackgroundoftheapplicant.
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
4. Toyourknowledgedoestheapplicantparticipateinanyofthefollowing?
_____DrugUsage
_____Smoking
_____Drinking
_____N/A
5. Haveyouhadanyoccasiontoquestionhis/hermoralcharacter?_____________________________________
6. Whatisthegeneralphysicalconditionofapplicant?_____________________________________________________
7. Doeshe/shehaveanymentalorphysicaldisabilities?___________________________________________________
8. Toyourknowledge,istheapplicantpromptinpayingdebts?___________________________________________
9. Doestheapplicant,inyourjudgment,displayfitnessandaptitudeforadiscipleshipprogram?
_________________________________________________________________________________________________________________
10. Inyouropinion,istheapplicantemotionallystable?_____________________________________________________
11. Wouldyouunhesitatinglyrecommendtheapplicant’sacceptancetoMaster’sCommission
Edmonton? ______Yes
_____No
Comments____________________________________________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
12. Theseobservationsarebasedonanacquaintanceoveraperiodof__________________years.
Comments____________________________________________________________________________________________________
_________________________________________________________________________________________________________________
Signature___________________________________________Date_____________________________
PrintName___________________________________________________________________________________________________________
Address_______________________________________________________________________________________________________________
Phone(_________)_________________________________________
MailingInstructions
Pleasemail/faxthisformto:
Master’sCommissionEdmonton
13470FortRd.NW,Edmonton,ABT5A1C5
fax:(780)472‐1383
Questions?Call780‐475‐1647
BiographicalStatement(tobecompletedbyapplicant)
Instructions:Pleasewriteashorttestimonystatementtoincludethefollowing
information:
[A]SalvationExperience[B]WaterBaptism[C]BaptismoftheHolySpirit[D]GoalsandDesiresforthe
Future[E]WhyyouwishtoattendMaster’sCommissionEdmonton
(minimumof250,maximumof500words‐pleaseusethespaceprovidedbelowortypeonaseparate
pieceofpaper)
NameofApplicant______________________________________________Date________________
Last First
Middle
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
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*Ifadditionalspaceisneededforanswers,pleaseuseanothersheetofpaper.
FundraisingPolicy
The$5300.00tuitioncoversaportionofthecostoftheentireyearperstudent.Master’sCommission
Edmontonhascommittedtoraisetheremainderofthebudgetthroughfund‐raising.Staffandstudents
arerequiredtobeinvolvedinthefundraisingeventsthroughouttheyear.
DisputeResolutionandDismissalPolicy
Master’sCommissionEdmontonStaffiscommittedtoresolvingalldisputesthatmayarisewithinour
studentbodyorstudentsandhouseparentsinaBiblicalmanner.ThiscommitmentisbasedonGod’s
commandthatChristiansshouldstriveearnestlytoliveatpeacewithoneanother(Matthew5:9and
Romans12:18).Wewillalwaysseekresolutionwiththestudentsinallmatters,andconsultationwith
students,staff,parents,andhouseparentswillalwaysbeourfirstandutmostpriority.
IntheeventthatastudentfailstohonourtheircommitmenttotheStudentHandbook,actionwillbe
takenaccordingtotheBiblicalprinciplesoutlinesinMatthew18:15‐17.Ourfirststepwillbetoaddress
thestudentandtheiractiononeonone.Ifatthispointthestudentdoesnotshowsignsofarepentant
heart,Master’sCommissionEdmontonleadershipandFortRoadVictoryChurchleadershipwilladdress
thestudent’sattitudeandactions.Ifallthesestepshavebeentakenandthestudentisstillunresponsive
tothecorrectionofMaster’sCommissionEdmontonandFortRoadVictoryChurchleadership,asalast
resort,dismissalmayresult.Wewill,however,giveeveryopportunityforthestudenttoremaininthe
program.Theoptionofaprobationperiodmayalsohelptoresolveindifferences.Ourcommitmentisto
Biblicallyresolveanyproblemsthatmayarise.
SignatureofApplicant
SignatureofParentorGuardian(ifstudentisaminor)
Date
Date
AuthorizationforTreatmentofaMinor
DearHealthCareprovider:
IfIamunabletobereachedtoprovideconsentformedicalcare,I,theundersignedparentorlegal
guardianof
__________________________________________________________________________________________________________________,
aminor,authorizethehouseparentsdesignedbyMaster’sCommissionEdmontonortheleadershipof
Master’sCommissionEdmontontoconsentinanyemergencysituationtoanymedicalorsurgical
procedureorhospitalcarerequiredfortheaboveminor.Hospitalcaremayincludeanylaboratorytests,
X‐rayexaminationsandanestheticrequired.Allmedicalcaremustbeacknowledgedasnecessarybyand
performedunderthesupervisionofaphysicianlicensedtopracticemedicineintheprovinceornationin
whichthestudentlivesortowhichthestudenthastraveled.
Inmyabsence,mychildmaybereleasedtothehouseparentsorleadersdesignedbyMaster’s
CommissionEdmontonfollowingcompletionoftreatment.
SignatureofParentorGuardian
Date
Date
SignatureofApplicant