EmailMe Form - DTS Experience, Health, and Consent Form

Which DTS are you applying to? *

September 3, 2018 - January 18, 2019

January 31, 2019 - June 21, 2019

What track focus are you applying to? *

Adventure

Abolitionist

Orphan Care

Classic

Name *

First Last

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Date of Birth *

MM / DD / YYYY

Picture of yourself *

Passport Number

Passport Expiration Date

MM / DD / YYYY

Gender

Female

Male

Marital Status

Single

Engaged

Married

Name of Spouse/Fiance

Accompanying Children

Emergency Contact Name *

Emergency Contact Phone *

Emergency Contact Email *

Home Church

Denomination

How do your spiritual leaders feel about you doing a DTS? *

Are you currently in school? *

Yes

No

Highest level of education completed *

What languages do you speak fluently?

Describe your family background and the circumstances of your childhood and teenage years. *

Is your family supportive of you doing a DTS? *

Do you have the money required to cover the DTS costs? If not, how much do you still need? *

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