Apply Now | Prairie 2 Pacific DTS

Application

Which program are you applying for?

Name*

First Last

Address*

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

Gender*

Gender

Phone*

Phone

Birthdate*

Birthdate

Email*

Email

Country of Birth*

Country of Birth

Marital Status*

*Note: We do not accept students who have children without full time childcare provided by someone else

Do you have a current passport?*

Yes
No

Do you have a travel Visa for Canada?*

Yes
No

Do you speak English fluently?*

Yes
No

Do you have your complete school fees?*

Yes
No

If not, how much do you currently have*

Describe your current relationship with the lord jesus. How and when did he become real to you?*

Explain in detail, two areas of your character you really want to grow.*

Please provide details about your current and past church involvement.*

Describe your relationship with your immediate family.*

Is your family in favour of you doing this DTS?*

Yes
No

Do you have health insurance coverage in Canada?*

Yes
No

If from outside Canada, do you have travel health insurance?*

Yes
No

Are you pregnant?*

Yes
No

Are you currently under a doctor’s care?*

Yes
No

Are you presently taking medication?

Yes
No

If so, please list*

Do you have any of the following medical conditions?

If you have any other medical conditions please list them

Are you allergic to any medication or food?

Do you have any physical impairments or health conditions which require special attention?*

Emergency Contact

Name*

First Last

Address*

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

Phone*

References

Please include at least two references that we can send forms to.

Reference 1*

First Last

Email*

Reference 2*

First Last

Email*