Helping Fulfill the Great Commission
APPLICATION FOR ADMISSION PASSPORT PHOTO
This information will be held Strictly Confidential.
Note:
The applicant is required to print the information in this form by themselves in
either English or Swahili languages. We will not accept any applicant who asks
someone to assist them print on this form.
People Group: (Nation)_______________________________________________________________________________
NAME: Last______________________ First _____________________ Middle________________________________
STREET: _________________________________________________________________________________________
SUB-COUNTY:___________________________ Village__________________ Postal Code_______________________
COUNTRY:_____________________________ Phone Number______________________________________________
PERSONAL EMAIL ADDRESS: ______________________________________________________________________
DATE OF BIRTH: ________________________________ (eg. 1st Jan 1999) Age________ Sex ________________
MARRITAL STATUS: MARRIED___ SINGLE___ DIVORCED ___ SEPARATED___ WIDOWED/WIDOWER___
PLACE OF BIRTH:____________________________________ CITIZENSHIP_________________________________
IF NOT A KENYAN CITIZEN STATE RESIDENCE PERMIT: _____________________________________________
OCCUPATION: ____________________________________________________________________________________
2. General Information
HAVE YOU HEARD ABOUT DISCIPLES OF JESUS MNISTRY? ________________________________________
WHAT DID YOU HEAR_____________________________________________________________________________
WHAT IS YOU OPINION ABOUT THE MISSION OF DJM_______________________________________________
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MONTH OF APPLICATION____________________________________ YEAR OF APPLICATION _______________
APPLICANT’S NAME ____________________________________________________ DATE ____________________
BELOW ARE ESSAY QUESTIONS THAT WILL HELP US GET ACQUAINTED WITH YOU AS AN APPLICANT.
PLEASE ANSWER THE QUESTIONS AS COMPLETELY AS POSSIBLE IN YOUR OWN WORDS.
1. HOW DO YOU HOPE DISCIPLES OF JESUS MINISTRY TRAINING WILL AFFECT YOUR LONG
TERM GOALS AND PURPOSE INLIFE?____________________________________________________
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2. PLEASE WRITE A BRIEF TESTIMONY ABOUT YOUR RELATIONSHIP WITH THE LORD,
TELLING SIGNIFICANT MOMENTS WHERE YOUR LIFE CHANGED AND YOUR RELATIONSHIP
GREW DEEPER WITH HIM.______________________________________________________________
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3. EDUCATIONAL BACKGROUND & WORK EXPERIENCE
HIGH SCHOOL ATTENDED (NAME) ______________________________________________________
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(CITY) (DATES ATTENDED) (YEAR OF GRADUATION)
COLLEGE OR UNIVERSITY ATTENDED (NAME) __________________________________________
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(CITY) (DATES ATTENDED) (DEGREE EARNED)
WERE YOU EVER SUSPENDED FROM HIGH SCHOOL OR COLLEGE? __ YES __ NO
IF YES, EXPLAIN ON SEPARATE SHEET. _________________________________________________
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WHAT ARE YOUR CAREER PLANS? _____________________________________________________
LIST ANY SKILLS OR EXPERIENCE YOU HAVE THAT MAY BE AN ASSET TO THE MISSION
AND YOUR CALLING TO MINISTRY AS YOU STUDY AND PARTNER WITH DJM. ____________
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4. CHURCH AFFILIATION: WHAT CHURCH DO YOU ATTEND REGULARLY? __________________________
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HOW LONG HAVE YOU BEEN A MEMBER OF THIS CHURCH? ______________________________________
CHURCH PHONE CONTACT: ____________________________________________________________________
DO YOU SERVE THE CHURCH IN ANY CAPACITY? __ YES __ NO
IF YES, EXPLAIN YOUR SERVICE AREAS ________________________________________________________
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5. ______________________________________________________________________________________________
HOW DID YOU BECOME ACQUAINTED WITH DISCIPLES OF JESUS MINISTRY:
WHERE DID YOU FIRST HEAR ABOUT OUR MINISTRY (DMJ)? __ FAMILY MEMBER __ FRIEND __
INTERNET __ CHURCH __ OTHER _______________________________________________________________
NAME AND RELATIONSHIP OF REFERRAL: ______________________________________________________
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APPLICATION STEP #2, PAGE 1
APPLICATION QUESTIONNAIRE
1. Have you ever been convicted of a criminal offense (misdemeanor or felony)? Yes No
If yes, explain number of conviction(s), nature of offense(s) leading to conviction(s), how recent was/were such
Offense(s) committed, sentence(s) imposed, and type(s) of rehabilitation.
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2. Have you in the past or are you currently struggling with alcohol or drug addiction? Yes No
If yes, explain, past addictions / current addictions, types of rehabilitation that you have gone through or are
currently going through.
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3. Spiritual:
Have you accepted Jesus Christ as your personal Savior? Yes No
Have you been baptized in much water? Yes No-When (Date of Baptism)? ________________________
Who taught you the Word? ___________________________________________________________________
Who baptized you? _________________________________________________________________________
What is your post Christian experience? _________________________________________________________
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Are you undergoing any form of persecution since your conversion to Christianity? ______________________
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4. Medical:
Are you presently under the care of a physician? Yes No If yes, please explain
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Do you have any physical limitations that would require assistance from us in order for you to be successful
during your time at DJM? ___________________________________________________________________
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6. Parents: (Please complete this section if applicant is under 18 years of age)
Name of Parents/Guardian: Address: ____________________________________________________________
City: ____________________________ State: _________________________Code: _____________________
Phone: ____________________________________ Email (If any): ___________________________________
I certify, to the best of my knowledge, that all of the answers and statements on this application are true and
give reliable information about the personality of the applicant.
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CONDITIONS OF ENROLLMENT
The training program at DISCIPLES OF JESUS MINISTRY is for the earnest Christian who
desire to grow in Christ and is sensitive to the many principles of Christian living that are found
in the Bible. The disciple makers imposes certain specific guidelines for the conduct of staff and
students. Although such man-made regulations cannot improve our standing in Christ, they can
strengthen the life, discipline, and testimony of both the individual and the DJM.
1) All students are expected to devote themselves unreservedly to their studies in lectures and
study periods and to conform willingly to the time table throughout the whole academic
year. Punctuality and cooperation are essential for the well-being of the whole student body
and for personal discipline.
2) All students are expected to help in the duties necessary to maintain the facilities and
grounds where any physical meeting will be held.
3) All students are required to complete all assignments. Students must also take notes during
classes and participate in discussions.
4) All students are expected to maintain a clean, neat and tidy appearance. Students should
show moderation and modesty at all times, no matter what the prevailing fashions may be
elsewhere. Cultural attires will be upheld and encouraged during your time with DJM to
help the evangelist identify with their own cultures before and after commissioning.
5) All students are required to abstain from practices expressly forbidden in Scripture,
including dishonesty, sexual immorality, and profanity. Students are also responsible to
guard themselves from sinful attitudes -- jealousy, pride, hatred, gossip, prejudice,
impatience, and worldliness. (Galatians 5:19-21)
6) All students are required to abstain from the use of tobacco (in any form), alcoholic
beverages and illegal drugs.
7) Where Scripture does not specifically dictate the believer’s actions in a given situation, we
are to live in accordance to the principles of love: honoring other believers above yourself,
(Romans 12:10) and not engaging in any behavior that might be a cause for stumbling or
offense. In addition, students should be careful not to participate in any activity which
would deaden the sensitivity of his conscience or hinder his spiritual growth.
8) DJM reserves the right to dismiss an evangelist who, in its judgment, is harming his/her
own spiritual growth and others around him by not conforming either to the stated
regulations governing student conduct or to the expressed principles, policies, and program
of the DJM.
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Instructions
To the Applicant: This reference form should be completed by your Pastor and mailed directly
by him/her to the Admissions Office.
To the Pastor: The applicant named below is applying for admission to DISCIPLES OF
JESUS MINISTRY discipleship training program. Serious consideration will be given to your
comments; therefore, we ask you to complete this form thoughtfully and prayerfully. This
reference will be kept private and confidential. Thank you for your assistance
Last Name first Name Middle Name
Name of Applicant: ___________________________________________________________
City State Code
Home Address: _______________________________________________________________
How long have you known the applicant? _________________ What Capacity? ____________
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How well do you know him/her? (Check one) __Very close; __personal relationship
Fairly well; __numerous personal contacts __Casually; few personal contacts __By name/
sight
To your knowledge, has the applicant made a personal commitment to Jesus Christ? __Yes
__No __I don't know
To what extent is the applicant engaged in the activities of your church? (Check One) ___
Enthusiastic; deeply involved ___Cooperative; usually willing to help ___Seldom participates,
although attends regularly ____Attends irregularly; shows little interest
In what form of Christian service has the applicant participated regularly? _________________
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What are the applicant's strong points? Weak points? (Include special abilities.) _____________
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Does the applicant have personality traits which impair his/her relationship with others? No ___
Yes, ___ Explain: ___________________________________________________________
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To your knowledge, does the applicant smoke? __________ Drink? ____________ Use illegal
drugs? _________________________ Comments ____________________________________
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To your knowledge, has the applicant ever been accused of and / or convicted of child abuse or
a crime involving actual or attempted sexual molestation of a minor? No Yes, explain: _______
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How do you rate this person in the following areas? Excellent, Average, Poor, or Unknown
Reliability: dependability, responsibility ___________________________________________
Maturity: personal development, ability to cope with life situations ______________________
Emotional stability: reaction to stress, poise, mood stability ____________________________
Motivation: genuineness & depth of commitment ____________________________________
Judgement: ability to analyze a problem ___________________________________________
Oral expression: clarity, coherence _______________________________________________
Interpersonal relations: rapport, cooperation, attitudes toward supervision ________________
Empathy: sensitivity to the needs of others __________________________________________
Leadership: creative thought, curiosity, self-confidence ________________________________
Personal appearance: cleanliness, grooming _________________________________________
Integrity:Honesty, Moral character Work habits, Stamina, Consciousness, perseverance,
resourcefulness, initiative ________________________________________________________
Please describe home factors which might affect the applicant's success at Disciples of Jesus
Ministry training program? ____________________________________________
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Does the applicant regularly give tithes to the Lord? Yes___ No ___ I don't know ___
Further comments you have regarding the applicant that would help in our evaluation: _______
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_____ I recommend ______I recommend with reservation ____I do not recommend
Please print the information requested below:
Name _______________________________________________________________________
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Position: _____________________________________________________________________
Sr. Pastor___________ Assoc. Pastor ______________ Youth Pastor ______________
Name of Church and Denomination _______________________________________________
________________________________________ Church Address_______________________
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_____ Street City(________) ___________________________ State Phone (______) _______
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Signature________________________________________________
Date______________________________
Note: Attach
1. Copy of National Identification Card
2. Copy of Birth Certificate
3. Copy of your Baptismal Certificate
