Name
*
First Name
Last Name
Email
*
Phone
*
Country
(###)
###
####
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Social Media Handles (Instagram, Facebook, TikTok, YouTube, etc.)
*
Country of Residence
*
Nationality
*
Date of Birth
*
(You must be at least 18 years old by the start of the program)
MM
DD
YYYY
Gender
Language(s) spoken and proficiency levels
*
When did you accept Christ as your personal Savior?
*
Have you been baptized in the Holy Spirit according to Acts 1:8 and Acts 2:4? How do you know?
*
Do you attend church regularly? How long have you been attending there?
*
Describe your relationship with your local church. If you aren’t involved, explain why.
*
Have you ever been asked to leave a school, church, or ministry? Explain if applicable.
*
Are you a member of your church?
*
Home Church Details
Name of Church, Senior Pastor’s Name, Church Address (Street, City, State/Province, Postal Code, Country), Church Phone Number
Name of Church, Senior Pastor’s Name, Church Address (Street, City, State/Province, Postal Code, Country), Church Phone Number
Please note that your response to this question will not affect your acceptance into the program. We ask this question simply to gain a deeper understanding of your spiritual journey and any unresolved experiences. Our goal is to create a supportive environment for growth, healing, and learning.
Marital Status
*
Name, Age, and Gender of Children
(if applicable)
Will you be attending with your spouse or children?
If children, how many? If married but applying without your spouse, include a note from your spouse explaining their feelings about your attendance and how it fits into your family calling.
Health of each attending family member
Excellent, Good, Fair, Poor
Blood Type (Optional)
Do you snore?
Are you or your children on medication? Please specify.
Any allergies or special dietary needs?
*
Any history of health conditions requiring special attention?
*
By submitting this application, you agree to the necessary medical treatment in case of emergency and are responsible for any incurred medical expenses during your involvement with Radical Love Asia Foundation. You also release Radical Love Asia Foundation, its staff, agents, and volunteers from any liability related to injury, damage, or loss during the program.
*
I agree to the Health Agreement
Did you graduate from high school or get a GED/equivalent?
*
Did you attend college/university? If yes, what was/is your major and graduation date?
*
Occupation
*
Have you ever used any of the following (Alcohol, Tobacco, Soft/Hard Drugs)? If yes, explain.
*
Any past or current addictions? Timeline, last occurrence, and level of freedom now.
*
Describe any struggles with mental health, including depression, self-harm, or suicide.
*
Have you had any involvement in the occult or cult practices? Provide details and dates.
*
Any past or current involvement in sexual sin (heterosexual, homosexual) or pornography?
*
Provide details and last occurrence.
History of eating disorders or compulsive behaviors?
*
Please provide a timeline.
Please describe any history of abuse (verbal, physical, emotional, or sexual).
*
Have you been arrested or convicted?
*
Provide details if applicable.
Have you been on a mission trip?
*
Please describe your participation.
Why are you attending this school? What are your plans after the program?
*
Interest in working with Radical Love Asia Foundation post-program? Which area of ministry/nation is on your heart?
*
List gifts or talents
(Example: Art, singing, playing instruments, worship leading, etc.)
Please list areas of expertise
(Example: Administrator, Construction, Teaching, Medical, etc.)
Provide one friend and one pastor reference (family members are not allowed).
*
(Name & Contact Information)
