Purelight Missionary Training Centre Student Application form Applicant Information First Name / Given Name Middle Name / Maiden Name Last Name / Family Name Date of Birth (yyyy-mm-dd) E-mail Address: Ex: name@domain.com Alternate E-mail Address: Ex: name@domain.com Identity Number (South African Citizens only)/ Passport Number Gender: Male Female Permanent Postal Address Street or P O Box City / Town State / Province Country Page 1
ZIP Code / Postal Code Telephone Home Telephone Number: Ex: (+27) 83 687 2377 Work Telephone Number: Ex: (+27) 83 687 2377 Mobile Telephone Number: Ex: (+27) 83 687 2377 Marital Status Status: Single Married Separated Widowed Divorced Years Married Spouse's Name Children Number of Children Legal Status Country of Citizenship (if you have dual citizenship please list both countries) If you are NOT living in your country of citizenship, what is your Legal Status in South Africa? Visa Permanent Residency Illegal Alien Not Applicable Type of Visa Page 2
Expiration Date Place of Birth City / Town State / Province Country Parent / Guardian or Close Relative Name Postal Address Street or PO Box City / Town State / Province Country ZIP Code / Postal Code Telephone Number Ex: (++00) 540 555-0123 E-mail Address Ex: name@domain.com Relationship to above Person Is this Person your Legal Guardian? Yes No Page 3
If you are NOT a citizen of South Africa AND have relatives or close friends living in South Africa, please list their Names, Addresses and Telephone Numbers Name: Address: Telephone: Name: Address: Telephone: Name: Address: Telephone: Church Affiliation Denomination: Ex: SDA, Baptist, Buddhist, Methodist, etc. Number of Years as Member: Church Name or Locality: Page 4
Postal Address Street or PO Box City / Town State / Province Country ZIP Code / Postal Code Telephone Number: Ex: (+267) 395 6780 E-mail Address: Ex: name@domain.com Enrollment Classification: Level 1 Classes Level 2 Classes Level 3 Classes Status: New College Entrant Transfer Anticipated Enrollment Year: Anticipated Enrollment Semester: January June To what major program of studies offered at PureLight College do you feel God's calling? Bible Worker Public Evangelism Health Ministry (Medical Missionary training) Undecided None Page 5
List all educational institutions that you have attended and the degrees you have received. List the most recent/highest qualification first. Alternatively, if you did not graduate from from high school: The names of your instructors A description of your training You will also need to send a copy of all your grade reports via e-mail or postal mail to the Dean of School, whose address is given at the end of this form. Work Experience III. Work Experience Are you presently employed? Yes No If not, why? If yes, what is your job? Page 6
Please list work experience you have had in past years. (including schools, businesses, jobs, etc.) Start with the most recent. Do you have any journeyman or higher trade skills? (Please list) Please list all computer programs with which you are familiar and a list of any certificates of completion for specific training courses you have taken Please list all languages in which you are fluent Can you type? Yes No If so, how many words per minute? Page 7
Legal Information Legal Information 1. Do you have an unpaid school account? Yes No If so, where? How much? (in Dollars or South African Rands) 2. Have you ever been asked to withdraw from school? Yes No If so, please state the reason: 3. Have you used alcohol, tobacco, or other mind-altering drugs or chemical substances in the last two years? Yes No If yes, please state the type: 4. Have you ever been convicted of any crime (other than minor traffic violations) or been sentenced to a corrective or penal institution? Yes No If yes, state the type of crime: If yes, state the amount of time served: Page 8
Suggested References High School or Academy Principal Name Postal Address Street or PO Box: City / Town: State / Province Country ZIP Code / Postal Code Telephone Number : Ex: (++00) 540 555-0123 E-mail Address: Ex: name@domain.com Instructor (within the last two years) Name Postal Address Street or PO Box: City / Town: Page 9
State / Province Country ZIP Code / Postal Code Telephone Number : Ex: (+27) 540 555-0123 E-mail Address: Ex: name@domain.com Minister / Pastor or Head Elder Name Postal Address Street or PO Box: City / Town: State / Province Country ZIP Code / Postal Code Telephone Number : Ex: (++00) 540 555-0123 E-mail Address: Ex: name@domain.com Employer or Work Supervisor Name Page 10
Postal Address Street or PO Box: City / Town: State / Province Country ZIP Code / Postal Code Telephone Number : Ex: (++00) 540 555-0123 E-mail Address: Ex: name@domain.com Self Evaluation 1. Are you presently active in daily devotions? Yes No If yes, please describe your present practice of them: 2. As you have prayed about your possible involvement as a student at PureLight Missions Training Center, what evidence have you already seen that God is directing you to submit this application? Page 11
3. When did you fully accept Christ as your Saviour, Master, and Lord, and yield your life to Him? 4. As a result of this acceptance, how has God changed your life? 5. As you became committed to following Him, how have your life goals changed? 6. Are you daily surrendering your life to God? Please explain. 7. Please assess your current ability to control your emotions. Page 12
8. Please assess your leadership ability. 9. Please assess your organisational ability. 10. Describe your study habits. Check all that apply. Punctual with assignments Only study to avoid failure Procrastinator Study best early in the morning Use spare time wisely Study best late at night Natural ability decreases need to study Study hard for my grades Other (explain below) Explain: Page 13
11. How supportive, financially, morally and spiritually are your parents (or guardians) of your decision to apply to PureLight? Please explain. After reading the appropriate sections in the PureLight Missions Training Center Catalog and Handbook, write your reaction to the following principles. Please answer questions 12-18 with 50 or more of your own words for each question. 12. Each student is expected to spend a minimum of 16 hours per week in useful labor as part of their overall education. No wages are paid. However, college credit is given for this as a class. 13. Each student is expected to actively participate in community service programs as a part of the outreach class requirements. Page 14
14. Dating and / or courting while training for a life calling distracts from the total commitment needed to meet educational goals. Flirting and close friendships between men and women decrease propriety and Christian reserve, and contribute to infatuation. Please respond. Page 15
15. Read the section on the dress policy in the handbook, and then write your response. 16. Read the section on the music policy, and then write your response. Page 16
17. PureLight Missions Training Center is established to educate and mature young men and women to be part of the final generation to take the message of the Everlasting Gospel to the world. Explain your own response to this goal. 18. The staff members of PureLight Missions are dedicated to your character development and will regularly counsel you about your attitudes and maturity. Please respond. 19. How do you relate to your peers? Check 2-4 items that answer this. Leader Independent Page 17
Follower Need More Tact Easily Influenced Good Listener Explain: 20. How do you think people in authority perceive you? Check 2-4 items that answer this. Cooperative Respectful Resentful Intimidated Understanding Antagonistic Suspicious Independent Explain: 21. List, in order, your four highest priorities in life. 1 2 3 4 22. Have you had or do you have any disabilities that would affect your work, studies, etc. Page 18
23. Do you plan to bring a vehicle with you to PureLight? Yes No VII. Financial Information Who is the person responsible for your account while at Purelight? Name Postal Address Street or PO Box: City / Town: State / Province Country ZIP Code / Postal Code Telephone Number : Ex: (++00) 540 555-0123 E-mail Address: Ex: name@domain.com Use this for any additional comments or to elaborate on any of the questions above. Page 19
Enter your full name The information on this form is true and accurate to the best of my knowledge Signature Page 20