LIVING WORD BIBLE COLLEGE

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1 LIVING WORD BIBLE COLLEGE APPLICATION FORM 2014/2015 Date received: Accepted: Y N Application Fee Paid $ Date: Tuition Paid $ Date: Acceptance Letter Sent: PERSONAL INFORMATION LEGAL NAME: Surname Given names CURRENT ADDRESS: Apt. # Street City Province Country Postal Code TELEPHONE: Current Occupation BIRTHDAY: Age SEX: MALE FEMALE Birthplace / City Country MARITAL STATUS: Single Married Separated Divorced Remarried Name of Spouse if married: Note: If your spouse plans to take classes at LWBC, please have him/her complete a separate application. I heard about Living Word Bible College via: (Name of Person) IMMIGRATION STATUS: Canadian citizen Permanent resident Out of Country Country of Citizenship Date of Entry * Note: International Applicants must also complete the International Student Form 1 P a g e

2 NEXT OF KIN: In case of medical or other emergency, indicate name and telephone number of person* to contact: Name Phone Relationship Address (if different from above) For International Students, this should be the name and address of the person you would like us to contact within North America. SPIRITUAL INFORMATION: Name and Address of Home Church Denominational Affiliation PERSONAL REFERENCES: Two Personal References are required using the forms at the end of this application. One must be completed by a Pastor, Youth Pastor or Christian Leader, and the other completed by an Adult Christian friend who is not a relative. The completed reference forms should be forwarded directly to Living Word Bible College by the individual completing the reference. For international students, reference forms may be submitted with the application package, however, they must be in a separate, sealed envelope. 2 P a g e

3 MEDICAL INFORMATION: Provincial Health Card Number: Province: I live out of country and will require international student insurance. 1. Please list any medications you must take on a regular basis 2. Have you ever received treatment for a mental disorder? No Yes, explain: 3. Check any of the following conditions that you have had and provide the approximate date: ADD, ADHD Asthma Diabetes Epilepsy Fainting Headaches Heart Problems Hepatitis Measles Mononucleosis Mumps Polio Rheumatic Fever Small Pox STD s Tuberculosis Typhoid Other: Anxiety Disorder Eating Disorders Social Difficulties Clinical Depression Allergies - Specify: We recommend that you have a medical checkup prior to arriving as a student at the Living Word Bible College. Please notify us of any medical condition which may interfere with your studies. Note: International students will require a complete medical checkup prior to receiving a Study Visa. 3 P a g e

4 FEE SCHEDULE 2014/2015 FULL-TIME STUDENTS Application Fee (Canadian Students) $ Send with this application Application Fee (International Students) $ Send with this application SEMESTER 1 SEMESTER 2 Tuition Fee & Room and Board $ $ Other Fees: o Note: International Students arriving with Sponsored financial support - Tuition & Room/Board fees must be paid in full (entire year) by the first day of class Wireless Internet access $ $ Official Transcript Fee $ per request PART-TIME STUDENTS Tuition Fee - per credit hour Audit Fee per credit hour $ ($360 / course) $ ($150 / course) Accommodations (Room and Board) for part-time students are available for a fee of $50 per day. 4 P a g e

5 Payment Options Application Fee: (Must be included with this application) $25 for Canadian students $100 for International students Tuition Fees: I am enclosing a money order or bank draft for a full year, in the amount of $6,000 CDN I prefer to make installment payments for each semester: Fall Semester - $3,000 CDN due First day of class in September 2013 Winter Semester - $3,000 CDN due First day of class in January 2014 Payment may also be made by Credit Card. Please charge my Visa (or) MasterCard for the amount of $ Name as it appears on Card Card # Expiry Date mm / yy Signature Date I certify that all the information in this application is complete and accurate. I understand that payment of all fees must be made as outlined in this application unless otherwise approved by the President of Living Word Bible College. If accepted, I will uphold the standards of the College with regards to moral and Christian conduct. I will abide by the College rules and discipline, and obey those in leadership at Living Word Bible College. Signed Date Please send application form and application fee of $25 (for Canadian Students) or $100 (for International Students) to: Living Word Bible College Box 969 SWAN RIVER, MANITOBA ROL IZO CANADA Or by to 5 P a g e

6 REFERENCE FORM #1 - Pastor, Youth Pastor, Christian Leader (non-relative): Applicant name: Please complete the following reference form with respect to the above mentioned applicant. The back side of this form may be used should you require more space to answer the questions. Please fill out this form and submit in a sealed envelope to the following address: Living Word Bible College, Box 969, Swan River, MB, R0L 1Z0, Canada Name: Organization: Address: Phone: How long have you known him / her? yrs. Does the applicant regularly attend your church? If not, please explain your relationship to the applicant. What ministries has the applicant been involved with in your church or youth group? _ Have you ever had occasion to question the applicant s moral conduct? Please explain. To your knowledge, does the applicant have addictive habits such as smoking, drinking or use of non-prescription drugs? Yes No Briefly describe the applicant s personality or character traits. Please comment on how well you would expect the applicant to succeed at Bible college with respect to the following areas: Academically, Socially, and Spiritually. Do you have any reservations in recommending the applicant for studying at LWBC? If yes, please explain. Yes No I declare that the contents of this confidential reference form are correct to the best of my knowledge. Signature: Date: 6 P a g e

7 REFERENCE FORM #2 - Adult Christian friend (non-relative): Applicant name: Please complete the following reference form with respect to the above mentioned applicant. The back side of this form may be used should you require more space to answer the questions. Please fill out this form and submit in a sealed envelope to the following address: Living Word Bible College, Box 969, Swan River, MB, R0L 1Z0, Canada Name: Organization: Address: Phone: How are you acquainted with the applicant? How long have you known him / her? yrs. To your knowledge, does the applicant regularly attend church? Are you aware of any ministries the applicant been involved with in his / her church or youth group? _ Have you ever had occasion to question the applicant s moral conduct? Please explain. To your knowledge, does the applicant have addictive habits such as smoking, drinking or use of non-prescription drugs? Yes No Briefly describe the applicant s personality or character traits. Please comment on how well you would expect the applicant to succeed at Bible college with respect to the following areas: Academically, Socially, and Spiritually. Do you have any reservations in recommending the applicant for studying at LWBC? If yes, please explain. Yes No I declare that the contents of this confidential reference form are correct to the best of my knowledge. Signature: Date: 7 P a g e

8 INTERNATIONAL STUDENT INFORMATION International Applicants: Must be at least 18 years of age; International Student Authorization for Studying in Canada: Anyone wishing to study in Canada who is not a Canadian citizen or permanent resident must obtain a student authorization before entering Canada. Those students in Canada on a visitor's visa must leave Canada and re-enter with the Student Authorization. Students should contact the nearest Canadian embassy, high commission or consulate once they are accepted to Living Word Bible College. To obtain your student authorization, the following documentation will be required: o Acceptance letter to Living Word Bible College, including information about t he expected time to complete the program. o Proof of financial support - the visa officer will expect you be able to support yourself during your program of study (may need to present financial documents to prove you have the necessary funds). Or, you may be required to show that you have support from another individual or organization (Sponsor). o Proof of medical clearance (depending on country of residence). Once this documentation is in order, Canadian Immigration authorities will issue an authorization / entry visa for Canada. This must be presented to the Immigration Officer when you enter Canada and they will issue the study permit. I understand the above requirements for acceptance to study at Living Word Bible College. I am applying to come to Canada for the sole purpose of studying at the Living Word Bible College. I understand that Living Word Bible College is an English speaking college and that I will be required to speak, read, write and study, in English while attending Bible College. By signing this form I understand the requirement stated and agree to its terms. Name: (Please print) Signature: Date: 8 P a g e

9 INTERNATIONAL STUDENT SPONSOR FORM I (sponsor) agree to pay for all fees, including tuition, room and board, for one year of studying at Living Word Bible College for (student). I understand that if the applicant receives a Canadian Student Visa and comes to North America through our letter of invitation but does not attend our college, or does not complete the college year as outlined, the money will not be refunded. Signature of Sponsor Date Payment options (choose 1): I am enclosing a money order or bank draft in the amount of $6,000 CDN). Full payment will be sent with the student upon arrival Payment may also be made by Credit Card. Please charge my Visa (or) MasterCard for the amount of $ Name as it appears on Card Card # Expiry Date / mm / yy Signature Date Sponsor contact information (please print clearly): Name of Sponsor Mailing Address City Province State Country Postal/Zip Code Address Telephone 9 P a g e

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