Clash of Minds

School of Evangelism

Application Form

Name
Physical address of residence
Do you have health insurance?
Are you happy to share a room with other students?
Have you ever been dismissed from any educational institution?

Education

Select Yes or No
Have you worked with an SDA ministry in the past?
Are you currently working with an SDA ministry?

Spiritual Life

Are you a baptized member of the SDA church?
Have you studied the fundamental beliefs?
Are you in agreement with ALL of them?
Do you attend church regularly?

Health and Participation Disclosure

Purpose: Our program includes a detox program, physical training, outdoor excursions, and on-site meals. To ensure your safety and provide any necessary accommodations, please complete this section truthfully and in full. All information is treated as confidential and shared only with staff directly involved in your care and participation (e.g. school coordinator, fitness trainer, kitchen staff, therapy deparment).

(1) Health and Medical Conditions

Please indicate whether you currently have, or have ever had, any of the following. If yes, please provide details in the space below.
Allergies or food intolerances
Medical conditions (e.g., diabetes, asthma, heart issues, high blood pressure)
Recent or past surgeries, injuries, or fractures
Mobility or exercise limitations
Chronic conditions affecting stamina, breathing, or joints
Mental health considerations (e.g., anxiety, depression, PTSD)
Eating disorders or specific dietary restrictions
Medication currently taken (prescription or over-the-counter)
Sensitivities to temperature, climate, or altitude
Any other relevant medical condition or special need

(2) Emergency Information

(3) Consent and Acknowledgement

Signature
I declare that the information provided above is true and complete to the best of my knowledge. I understand that failure to disclose relevant health information could place myself or others at risk. I consent to the program coordinators sharing relevant health information with authorized staff when necessary to ensure my safety and wellbeing.

Additional info

Please share a bit about yourself in the following sections:

Mental Health

Personal Background & History

References

Please complete the following references (i.e. people we could get in touch with to get to know you better):

Please complete details for all 3 references

Full name, Phone number, Email address
Full name, Phone number, Email address
Full name, Phone number, Email address