MISSIONAL TRAINING

CERTFICATE IN MISSIONAL LEADERSHIP - Endorsed by TQUK

APPLICATION for Enrollment

Note that this application form does not save your data if only partially completed. If you refresh the page, your data will reset. If you are not able to complete the application in one sitting, you should save your data elsewhere and come back to complete the form. Please fill in all required fields. Fields marked in RED are required.

1. PERSONAL DETAILS

Male

Female

Date of Birth

Age

First / given name

Surname / family name

Address

Country

City

Post Code

Skype Account

Email Address(es)

Mobile Number

Home Telephone

Emergency Contact Number

Emergency Contact Name

Emergency Contact Email

2. OCCUPATION

Please provide details of your previous employment.

Please provide details of your recent occupation, the nature of your work and how long you have been in this occupation.

Please provide details of your experience in Christian ministry (e.g. preaching, teaching, evangelism, etc.)

Please provide the name of the church you currently attend.

To which Christian denomination do you belong / are most associated with?

3. CHRISTIAN ASSOCIATION

Any additional Comments:

Add text that offers some clarification or options relevant to the choices offered, or an input box for comments from the candidate, or even perhaps the general start times for the modules, if they are static throughout any given year.

4. SELECT THE PROGRAM YOU WISH TO STUDY

5. HOW DID YOU HEAR ABOUT Engage Missional Training?

Church Leaders

Other:

Website

Recommendations

EMT Graduates

Do you have access to printing facilities:

Do you have access to scanning facilities:

Yes

No

Yes

No

None

Some

Lots

None

Some

Lots

Reading and responding to blogs

None

Some

Lots

None

Some

Lots

Posting of forums

Email

None

Some

Lots

Please indicate the extent of your experience of the following:

Yes

No

Yes

No

Yes

No

Yes

No

Do you have a Skype account?

Do you have a Twitter account?

Do you have a Facebook profile?

Do you have a blog?

No - Explain what access you can obtain

Yes-Broadband

Yes-Dial-up

Do you have daily access to the internet?

Yes

No

Do you have a webcam?

Other - Please specify:

Apple

Windows

What type of operating system do you use?

Yes

No

Do you have daily access to a personal computer?

6. COMPUTING EXPERIENCE & ABILITY

Yes

No

Yes

No

Yes

No

Yes

No

Produce .avi video files

Produce .mp3 files

Read and produce .pdf documents

Read/produce/edit .doc and .docx files

Do you have the hardware and software to:

Uploading video content

Google search

Relation to you

Email Address(es)

Mobile number

Home telephone

Surname

First/given name

Vicar

Minister

Pastor

Elder

Please give the name and address of a Christian leader to whom we may contact for a character reference.

Relation to you

Email Address(es)

Mobile number

Home telephone

Surname

First/given name

Relation to you

Email Address(es)

First/given name

Home telephone

Mobile number

Surname

Please give the names and all contact details of two referees who can usefully comment on your academic ability and potential. Normally these will be people who have taught you in the past.

7. REFEREES

If you do not obtain an award, how do you plan to pay for your fees and travel expenses?

Please provide details of any scholarship or grant application made for your proposed course, giving name, value and duration. Please state if the scholarship has already been awarded or if still pending.

8. FINANCE

B. Why do you wish to study?

C. Why have you chosen Engage Missional Training?

D. What do you expect to achieve from this programme?

E. Is your answer in (D) above what you would like to pursue as a career after Engage Missional Training?

A. Please explain briefly how and when you became a Christian:

9. PERSONAL STATEMENT

A social / communication impairment such as Asperger's syndrome / or other autistic sectrum disorder

A specific learning difficulty such as dyslexia, dyspraxia or AD(H)D or all of them

No known disability

Please indicate from the list below which statement most closely reflects your own situation concerning disabilities:

**Decisions regarding your application will not be based solely on answers to the questions in this section.

10. HEALTH / MEDICAL QUESTIONNAIRE:

I understand that the school reserves the right to require further information from my medical practitioner if this is deemed necessary.

A disability, impairment or medical condition that is not listed above

Deaf or a serious hearing impairment

If you are a UK applicant, you must have a GCSE grade C or equivalent competence in English language. Please provide a copy of you most recent English qualification.

Upload

1 month

2 months

3 months

If not, when do you intend to take the exam?

Upload

If you have answered 'yes' above, please provide a copy of your results.

Yes

No

Have you taken an IELTS Test?

If English is not your first language and you don't have any English qualifications, it is necessary to take the International English Language Testing Service (IELTS) examination and gain a score or 6.5.

What is your first language?

11. ENGLISH LANGUAGE COMPETENCE (UK/EE APPLICANTS)

Have you had any dealings with any statutory authorities (e.g. the police, social services, etc.) in regard to issues relating to offences against children, young people and/or vulnerable adults? If yes, please give details

Do you have a criminal record or have you ever received a caution from the police? If yes, please give details.

12. DISCLOSURE

Printed Name

Date

I agree any statement or statements on this form that prove to be untrue or purposely misleading will cause the application to be cancelled.

By signing this application, I consent to the processing of this data by Engage Missional Training for educational and statistical purposes under the provision of the 1998 Data Protection Act.

I confirm that the information given in this form is true, complete and accurate.

13. DECLARATION

Please ensure that you have filled in all the required data fields and use the button below to submit your application.

An error occurred. Please complete all the required fields marked in RED

Your content has been submitted

MISSIONAL TRAINING

CERTFICATE IN MISSIONAL LEADERSHIP - Endorsed by TQUK

APPLICATION for Enrollment

1. PERSONAL DETAILS

2. OCCUPATION

Please provide details of your previous employment.

Please provide details of your recent occupation, the nature of your work and how long you have been in this occupation.

Please provide details of your experience in Christian ministry (e.g. preaching, teaching, evangelism, etc.)

Please provide the name of the church you currently attend.

To which Christian denomination do you belong / are most associated with?

3. CHRISTIAN ASSOCIATION

Any additional Comments:

Add text that offers some clarification or options relevant to the choices offered, or an input box for comments from the candidate, or even perhaps the general start times for the modules, if they are static throughout any given year.

4. SELECT THE PROGRAM YOU WISH TO STUDY

5. HOW DID YOU HEAR ABOUT Engage Missional Training?

Do you have access to printing facilities:

Do you have access to scanning facilities:

Reading and responding to blogs

Posting of forums

Email

Please indicate the extent of your experience of the following:

Do you have a Skype account?

Do you have a Twitter account?

Do you have a Facebook profile?

Do you have a blog?

Do you have daily access to the internet?

Do you have a webcam?

Other - Please specify:

What type of operating system do you use?

Do you have daily access to a personal computer?

6. COMPUTING EXPERIENCE & ABILITY

Produce .avi video files

Produce .mp3 files

Read and produce .pdf documents

Read/produce/edit .doc and .docx files

Do you have the hardware and software to:

Uploading video content

Google search

Please give the name and address of a Christian leader to whom we may contact for a character reference.

Please give the names and all contact details of two referees who can usefully comment on your academic ability and potential. Normally these will be people who have taught you in the past.

7. REFEREES

If you do not obtain an award, how do you plan to pay for your fees and travel expenses?

Please provide details of any scholarship or grant application made for your proposed course, giving name, value and duration. Please state if the scholarship has already been awarded or if still pending.

8. FINANCE

B. Why do you wish to study?

C. Why have you chosen Engage Missional Training?

D. What do you expect to achieve from this programme?

E. Is your answer in (D) above what you would like to pursue as a career after Engage Missional Training?

A. Please explain briefly how and when you became a Christian:

9. PERSONAL STATEMENT

Please indicate from the list below which statement most closely reflects your own situation concerning disabilities: **Decisions regarding your application will not be based solely on answers to the questions in this section.

10. HEALTH / MEDICAL QUESTIONNAIRE:

If you are a UK applicant, you must have a GCSE grade C or equivalent competence in English language. Please provide a copy of you most recent English qualification.

If not, when do you intend to take the exam?

If you have answered 'yes' above, please provide a copy of your results.

Have you taken an IELTS Test?

If English is not your first language and you don't have any English qualifications, it is necessary to take the International English Language Testing Service (IELTS) examination and gain a score or 6.5.

What is your first language?

11. ENGLISH LANGUAGE COMPETENCE (UK/EE APPLICANTS)

Have you had any dealings with any statutory authorities (e.g. the police, social services, etc.) in regard to issues relating to offences against children, young people and/or vulnerable adults? If yes, please give details

Do you have a criminal record or have you ever received a caution from the police? If yes, please give details.

12. DISCLOSURE

13. DECLARATION

Please ensure that you have filled in all the required data fields and use the button below to submit your application.

Please indicate from the list below which statement most closely reflects your own situation concerning disabilities:

**Decisions regarding your application will not be based solely on answers to the questions in this section.