Apply for your BCC! School Application (BCC) 1Name & Contact2Personal Info3Personal History4Health 5Reference 6Application Documents and Fee Which quarter are you applying for?*September 2024April 2025Confirm Email* Phone (home)*Phone (mobile)Marital Status*SingleMarriedSeperatedDivorcedWidowedGender*MaleFemaleBirthday* MM slash DD slash YYYY Personal InfoCountry of Citizenship*Country of Birth*Country of Residency*Spouse accompanying you?* Yes No Children accompanying you?* Yes No Address InformationPrimary Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Passport InformationDo you have a passport?* Yes No Name on Passport* First Middle Last Passport Issued* AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Passport Expiry* MM slash DD slash YYYY YWAM HistoryWhen and where did you complete your Discipleship Training School?*Please list any secondary schools/seminars you have completed within YWAM and when and where you graduated (this includes staffing roles):How did you hear about the BCC at YWAM Honolulu?Do you have any outstanding financial balances with any schools or staffing commitments at any other YWAM location or campus?*Are you interested in the option, one-month outreach after graduating from the BCC?Personal HistoryPlease describe your conversion experience and your present relationship with the Lord.*What areas of your life are you hoping to grow and develop in and through this program?*Do you feel that God has given you, or is leading you, to any particular area of ministry?*What church involvement have you had?*How would you describe your relationship with your family?* The following questions are an assessment to determine how the school staff might best serve you if you are accepted into the school program. Included are potential areas of struggle that will likely surface during the program and discipleship process. Please answer the following to the best of your ability. The subjects are sensitive, so thank you in advance for your honesty and transparency. Are you currently taking and psychiatric medication?* Yes No If yes, please describe what the medication is for.Have you ever had any mental health issues (anxiety, depression, suicidal ideation or attempts, eating disorder, self-harm, etc.)?* Yes No Please describe.Have you ever struggled with substance abuse (i.e. drugs, alcohol)?* Yes No Please describe.Have you suffered any type of abuse or trauma in your life?* Yes No Please describe.Have you ever been arrested or convicted of a crime?* Yes No Please describe.Health HistoryCheck all the apply Skin Condition Eye Trouble Ear Trouble Head Injury Recurrent Headache Epilepsy Fainting Spells Mental/Nervous Disorders Depression Paralysis Insomnia Shortness of Breath Hay Fever/Asthma Allergies Heart Trouble High Blood Pressure Low Blood Pressure Rheumatism/Arthrtis Back Problem Dislocation of Joints Broken Bones Stomach/Duodenal Ulcer Sexually Transmitted Disease Surgery Appendectomy Tonsillectomy Hernia Repair Jaundice Hepatitis Intestinal Troubles Recurrent Diarrhea Diabetes Kidney Disease Anemia Gall Bladder Problems Cancer Female Conditions Irregular Periods Severe Cramps Excessive Flow Now Pregnant Specify AllergySpecify SurgerySpecify Female ConditionOther Illness of ConditionsAre you presently under doctors care?How would you rate your overall health condition?Are you presently taking any medication?Are you allergic to any drugs/medications? If so, please specify:Are you now receiving or did you ever receive compensation for disability from any source?Do you have any physical impairment, handicaps or health conditions which require special attentions?Disease HistoryCheck all that apply Chicken Pox Measles (Ruebella) Measles (Rubeola) Mumps Pertussis Scarlet Fever Tuberculosis OtherIf checked, please specifyFamily HistoryCheck all that apply Tuberculosis Diabetes Kidney Disease Heart Disease Hypertension Arthritis Stomach Disease Hay Fever/Asthma Epilepsy/Convulsions Cancer Most Recent YWAM Leader Reference:Last school director/leader, or staffing supervisorFirst Name*Last Name*Email* Additional Leadership ReferencePastor, mentor, bible study leaderFirst Name*Last Name*Email* Application DocumentsConsent I agree to the Moral Standard AgreementConsent I agree to the Release of LiabilityConsent I agree to the Statement of Burial
