Iris Ministries, Inc. | Iris Harvest School of Missions

Online Student Application Form (Confidential)

We are inviting those who have a clear call to missions.

Although couples and families are applying as a team, we ask that the husband and wife please submit all three forms individually. We need a separate student application, pastor reference, and friend reference for each person.

Also, please note that all applicants must be 18 years of age or older before school begins in order to apply.

School and Outreach Selection

Upcoming School(s)		School HS9A, Oct 17 - Dec 15, tuition $2400, Pemba, Mozambique, includes $200 non-refundable application processing fee
Outreaches		HS9B, 6 days in the bush-bush of Mozambique. You will have time to be home for Christmas. , Dec 16 - Dec 21, $300
		HS9C, Mozambique and International Outreaches. International outreach locations and costs will be posted when available. We will also have an Asian outreach which will be February 1-23, 2009. , Dec 16 - Dec 31 (Cost will be listed when available)
		No Outreach Extension

Personal Information

*NOTE: Please remember for each applicant 18 years and older, we must have a student application, pastor reference, and friend reference. Please follow up with your references to make sure they are submitted in a timely fashion as we do not begin the review process until we have received all three documents.

First Name / MI
Last Name
Address
City / State / Zip Code
Country
Email Address
Website
Home Phone
Cell Phone
Gender Male Female
Date of Birth
Place of Birth
Height
Weight
Resident Nation
Nationality
Indicate language(s) and proficiency of each you speak

Emergency Contact Name
Emergency Contact Phone Number
Emergency Contact Email
Emergency Contact Relationship

Family Information Marital Status Single Married
Spouse Name
Spouse Age
Spouse Birthdate
Spouse Nationality
Names and Ages of Children

Will you be attending with your spouse or children? If children, how many? If you are married and applying without your spouse, please have your spouse briefly indicate how they feel about you leaving them for school and how attending fits into your family as a call.

Family Situation Details

HEALTH INFORMATION Full Name
If attending, family names
Are you or any attending children on medication? Yes No
If yes, please specify
Are you or any attending children allergic to any medications? Yes No
If yes, please specify
Do you or any attending children have a history of depression, mental illness or psychiatric treatment? Yes No
If yes, please specify
Do you or any attending children have any physical impairments, handicaps or health conditions that require special attention (this includes food allergies)? Yes No
If yes, please specify
Blood type(s)

(Be certain this is accurate. If you are not certain, have your blood typed and recorded for emergency purposes)

Please rate the health of each member attending

By submitting this application, in case of emergency, you hereby agree to the performance of such treatment, including anesthesia and surgery, or any other treatment that an attending doctor or physician may deem necessary.

You agree to meet any and all medical expenses that are incurred during the course of involvement with Iris Ministries, Inc.

You also do hereby release Iris Ministries, Inc., its staff, agents and volunteer assistants from any liability whatsoever arising out of any injury, damage or loss sustained by said persons during the course of involvement with Iris Ministries, Inc.

Personal Background

Have you ever been involved in any of the following areas? If so, please explain the circumstances briefly, comment on your current position with each of these areas, how long it has been since you have participated in these, what ministry you have had to overcome them, and what level of freedom you are walking in now.

*NOTE: All fields in this section are required. If a question does not apply to you, then please write "N/A" into the field.

*NOTE: We realize that the following questions are personal. Please be assured that all answers are held in strict confidentiality and are not the basis for school acceptance.

Have you used any of the following substances?

Alcoholic Beverages

Tobacco

Soft drugs such as marijuana

Hard drugs such as cocaine, heroin or chemicals

None

Addictions:
Psychiatric treatment (please describe treatment received, dates and lingering difficulties):
Occultic or cult practices (satanism, witchcraft, Hinduism, Buddhism, Islam, new age, eastern mysticism, naturalistic philosophies, Mormanism, etc):
Heterosexual sin including pornography and promiscuity:
Homosexual activity:
Eating disorders:
Compulsive behaviors:
Do you have a history of abuse (verbal, physical, emotional or sexual)?

Testimony

Please complete a 400-500 word testimony of your life that includes the following: relationship with your father, mother and close family members past and present; childhood and teenage years; when and how did your conversion to Jesus change your life; describe your spiritual growth; and comment on your devotional life.

Please briefly describe your relationship with your local church. If you aren't involved in a church, please explain why.

Have you been on a mission trip? Describe your participation in missions.

Goals and Expectations

Please state your reasons for attending the school of missions in Pemba?

Briefly, what are your plans after the school.

If you are interested in working with Iris Ministries after graduation, what is your area of calling? Do you currently have a specific nation on your heart?

Talents Level of Education
Gifts or Talents
Please check any of the areas that apply:

Nurse

Architect

Mac User

Doctor

Gardener

Pastor

Mechanic

Farmer

Teacher

Electrician

Administrator

Construction

Bookkeeper

Tailor

Plumber

Computer

Housekeeper

If teacher, what do you teach?
Do You Sing? Yes No
Do you play an instrument? Yes No

If yes, what instrument?
Can you teach your instrument? Yes No
Are you a worship leader? Yes No
Can you do sound and/or projectors for outreach? Yes No
Do you have a truck license? Yes No
Do you have an International Drivers License? Yes No