Waldensian Center Application Form

Personal Information:

Date:

*First Name MI *Last Name:

*Date of Birth Age: Gender: Male Female

Marital Status: Single Married

Are you currently employed? Yes No
If yes, where do you work and what do you do?

Phone: Home Cell (optional):

Mailing Address:

*Email:

*Please elaborate on your religious experience, background and walk with God:


Emergency Contact 1:

*Name: First *Last:
*Phone: Home Cell (optional):

Mailing Address:

Emergency Contact 2: (Optional)

*Name: First *Last:
*Phone: Home Cell (optional):

Mailing Address:

Enrollment

I am Applying for: 1 Year Program; 1st Term; 2nd Term; 3rd Term; 4th Term

By what transportation do you plan to get to school?

When do you plan to arrive?

What do you hope to learn at the Waldensian Center?

What do you hope to do with what you learn?

What are your reasons for attending?

Previous Education

Home School:
Years attended: What levels have you completed?

High School:
Years attended: Did You graduate?

Vocational (Trade) School:
Name/Place: Years attended:
Did You graduate? Vocation Studied:

College:
Name/Place: Years attended:
Did You graduate? Major:

What level of Math are you proficient in? Geometry; Algebra; Other (Calculus, Trigonometry etc.. )

How strong do you consider your Language and Writing skills?

In what areas in Language/Writing do you think you need improvement?

List any foreign languages you know or are learning and how proficient you are in them.

List any trades or skills you are competent in:


Spiritual Life

How long have you been a Christian?

Have you ever been arrested or charged for a criminal offense? If yes, please explain:

What denomination are you currently a member of?

If you're not a member of any denomination, what denomination do your beliefs define you as?

When did you accept this faith?

Have you ever been a member of the Seventh Day Adventist Church? Yes No

What Spirit of Prophecy books have you read?

What evangelistic activities do you enjoy participating in?


References
Please provide at least two non-relative references, and let them know that we will be contacting them to ask about you.

Reference 1
Name: Relation:
Phone: E-mail:

Reference 2
Name: Relation:
Phone: E-mail:

 

Waldensian Center as a School

Please check the buttons next to each statement that you agree with:
* I agree to the fact that Waldensian Center is not accredited and does not plan to be accredited.

* I know and accept that Waldensian Center is non-trinitarian, and holds the Biblical truth about the Godhead as one of their foundational doctrines.

* I agree that practical work is an important part of true education and therefore am aware that I will be involved in useful labor on a daily basis.

* I am willing to be part of the outreach to the community with the school for evangelistic endeavors.

* I agree to abide by the lifestyle standards given in the Bible and S.O.P while I am at the school.

 

Medical History

If you can not remember specific details fill it in the best you can.

Allergies:
None Bee Sting Poison Oak

Meds:

Food:

Other:

 

Current Medications/herbs: None
If yes, please list:

Current/Chronic Medical Conditions: None
If yes, please list:

 

Past Medical Problems - Please indicate whether you have had any of the following medical problems and when you had them: None
Heart disease (specify type)
High blood pressure High cholesterol
Diabetes Thyroid problem
Asthma/Lung disease Kidney disease
Hepatitis A Hepatitis B
Other: (specify):

 

Surgical History: Please list all prior operations and when you had them

Do you wear Glasses or Contacts: Yes No

 

Tobacco Usage:
None Currently using Prior Use; Year started:
When ended:

 

Recreational Drugs - Have you ever used?
Yes No If so when was last use?

Alcohol Use - Have you ever used?
Yes No If yes when was last drink?

Current Lifestyle

Diet /Exercise: My current diet is: Satisfactory Unsatisfactory;
Concerns:

 

My current exercise/activity level is: Satisfactory Unsatisfactory
Concerns:

My current weight is: Satisfactory Unsatisfactory
Concerns:

I have Have not: previously used diet or exercise to gain/lose weight.

I have Have not: previously used medication or supplements to gain/lose weight.

How would you rate your general health? Excellent Good Fair Poor