BHAKTIVEDANTA COLLEGE
STUDENT APPLICATION FORM
Date:
Personal data:
First Name:
Last Name:
Gender:
Middle Name:
Nationality:
Date of Birth (dd/mm/yyyy):
Passport number:
Place of Birth (City, Country):
Place of issue:
Initiated Name (if valid):
Expiry Date:
Year of Initiation:
Spiritual Master:
Please list your present address:
Street:
City:
State & Post Code:
Home Phone:
Work Phone:
Email:
Is this the address to which you will return if, for some reason, you decide to quit your studies at Bhaktivedanta College?
Please list your previous addresses (for the last five years). Use additional sheets if necessary:
1. Street:
City:
State & Post Code:
2. Street:
City:
State & Post Code:
3. Street:
City:
State & Post Code:
Bhaktivedanta College a.s.b.l., Petite Somme 10, 6940 Septon-Durbuy, Belgium
Email: [email protected] • Web: www.bhaktivedantacollege.com • Tel: +32 86 323277 • Fax: +32 86 322029
Bank: Dexia 068-2456949-63 • IBAN: BE40 0682 4569 4963 • BIC: GKCCBEBB
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Bhaktivedanta College a.s.b.l., Petite Somme 10, 6940 Septon-Durbuy, Belgium
Email: [email protected] • Web: www.bhaktivedantacollege.com • Tel: +32 86 323277 • Fax: +32 86 322029
Bank: Dexia 068-2456949-63 • IBAN: BE40 0682 4569 4963 • BIC: GKCCBEBB
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Parents data:
Parents' Names:
Street:
City:
State & Post Code:
Home Phone:
Work Phone:
Email:
Who should we contact in case of emergency?
Name:
Relationship with you :
Street:
City:
State & Post Code:
Home Phone:
Work Phone:
Email:
Personal health information:
Do you have any major health care problems? If so, please explain:
Do you take any medications?
Please describe your educational background, including dates and names of institutions for degrees / certificates earned.:
Date:
1.
2.
3.
4.
5.
6.
7.
Name of institution / certificates earned
-
Do you have a Bhakti Shastri Degree?
Year of degree:
Have you ever served in the Military?
Are you / Have you ever been /married?
Number of children?
Please tell us why you would like to attend Bhaktivedanta College?
Bhaktivedanta College a.s.b.l., Petite Somme 10, 6940 Septon-Durbuy, Belgium
Email: [email protected] • Web: www.bhaktivedantacollege.com • Tel: +32 86 323277 • Fax: +32 86 322029
Bank: Dexia 068-2456949-63 • IBAN: BE40 0682 4569 4963 • BIC: GKCCBEBB
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Please tell us something about your aspirations in life!
References:
Please submit two references from people who know you well but are not family - this would include your initiating spiritual master.
Preferably these persons will have served as your authority in some capacity or worked with you for an extended period of time, within
the last 3-5 years.
1st reference:
Relation:
Address:
Dates:
Phone:
Email:
2nd reference:
Relation:
Address:
Dates:
Phone:
Email:
ISKCON references:
Please list services you have performed within ISKCON for the last ten years. List types of service performed, dates, temple
authority's name and position, Email, address, and phone number.
1. Service performed:
Dates:
Temple authority’s name and position:
Email:
Address:
Phone:
2. Service performed:
Dates:
Temple authority’s name and position:
Email:
Address:
Phone:
Bhaktivedanta College a.s.b.l., Petite Somme 10, 6940 Septon-Durbuy, Belgium
Email: [email protected] • Web: www.bhaktivedantacollege.com • Tel: +32 86 323277 • Fax: +32 86 322029
Bank: Dexia 068-2456949-63 • IBAN: BE40 0682 4569 4963 • BIC: GKCCBEBB
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3. Service performed:
Dates:
Temple authority’s name and position:
Email:
Address:
Phone:
4. Service performed:
Dates:
Temple authority’s name and position:
Email:
Address:
Phone:
Criminal / Abuse Screening
If you answer "Yes" to any of these questions, you may explain your answer on the back of this sheet. Or, if you prefer,
you may decline to answer any one of these questions, or you may discuss your answer(s) in confidence with the
interviewer, rather than answering on this form. Answering "Yes", or leaving any question unanswered, will not disqualify
an applicant. (Please circle answer, or make it bold)
Have you even been convicted of a major crime? ______________________________________________ YES / NO
Have you ever been charged or convicted of a minor crime in the last 7 years? _________________________ YES / NO
Have you ever been convicted on any domestic violence charges? _________________________________ YES / NO
Were you a victim of abuse or molestation while a minor? ________________________________________ YES / NO
Have you ever been accused of abusing a child? ________________________________________________ YES / NO
Have you ever abused a child? _____________________________________________________________ YES / NO
Have you ever been treated for any mental illness? ______________________________________________ YES / NO
Statement of Release and Consent
The information contained in this application is correct to the best of my knowledge. I authorize any references or
temples listed here to give any information (including opinions) that they may have regarding my character. In
consideration of the evaluation of this application by Bhaktivedanta College, I hereby release any individual, temple,
youth organization, charity, employer, reference or any other person or organization, including record custodians, both
collectively and individually, from any and all liability for damages of whatever kind or nature.
I also give my consent to Bhaktivedanta College, to conduct any other screening processes or background investigations
that they deem necessary. I understand that my acceptance in any position applied for will be pending successful
completion of the screening process.
Should my application be accepted, I agree to be bound by the Bylaws and policies of the International Society for
Krishna Consciousness.
I FURTHER STATE THAT I HAVE CAREFULLY READ THE FOREGOING RELEASE AND KNOW
THE CONTENTS THEREOF AND I SIGN THIS RELEASE AS MY OWN FREE ACT. THIS IS A
LEGALLY BINDING AGREEMENT WHICH I HAVE READ AND UNDERSTOOD.
Bhaktivedanta College a.s.b.l., Petite Somme 10, 6940 Septon-Durbuy, Belgium
Email: [email protected] • Web: www.bhaktivedantacollege.com • Tel: +32 86 323277 • Fax: +32 86 322029
Bank: Dexia 068-2456949-63 • IBAN: BE40 0682 4569 4963 • BIC: GKCCBEBB
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Admission fee
The admission fee of 50 Euros must be paid either to our bank account or by credit card:
Bank account details:
DEXIA, avenue Pacheco 44, 1000 Bruxelles, Belgium
Bank account number: 068-2456949-63
IBAN: BE40 0682 4569 4963
BIC: GKCCBEBB
Important! Please make sure that you cover the bank fees on both sides so that we get the full amount of 50 Euro on our
account. It happens frequently that we receive less than 50 Euro because the sender did not cover the bank fees in
Belgium. Please specifically indicate this to your bank when you make the transfer.
Credit card payment:
If you want to pay by Credit card, please contact us at <[email protected]> and we will inform you how to
complete the transfer.
The admission fee is not refundable if the potential student is not accepted or later withdraws his or her registration.
Applicant's Signature:
Dates:
Dates:
Bhaktivedanta College a.s.b.l., Petite Somme 10, 6940 Septon-Durbuy, Belgium
Email: [email protected] • Web: www.bhaktivedantacollege.com • Tel: +32 86 323277 • Fax: +32 86 322029
Bank: Dexia 068-2456949-63 • IBAN: BE40 0682 4569 4963 • BIC: GKCCBEBB
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BHAKTIVEDANTA COLLEGE
Student Guidelines Agreement
All new students will be enrolled for the first trimester on a trial basis. This will allow students to more closely examine the program at
Bhaktivedanta College and thus facilitate their making a lasting commitment to the program. Furthermore, it will allow the
administration to work with the new students and ascertain their ability to meet the program's spiritual and academic requirements.
Bhaktivedanta College offers academic, vocational, and spiritual training to students who are committed to a life of study and spiritual
practice during their stay at the College. The main rules for ashram-resident students are as follows:
1.
General
a.
To follow the regulative principles of abstinence from eating meat, fish, or eggs; intoxication of any kind, illicit sex, and
gambling.
To attend the morning temple programme on a daily basis and to daily chant 16 rounds of japa (or an agreed number of
rounds approved by the ashrama supervisor for non-initiated students).
To participate in all the scheduled courses and training sessions.
To act respectfully and to cultivate an attitude of service towards all community members and visiting guests.
To be considerate to others in communal living. This includes avoiding banging doors, playing loud or mundane music,
talking or singing loudly when it disturbs others, and to keep silence in the ashramas after 9.00 P.M.
To perform assigned services that are part of the training programme or communal requirement.
To avoid inviting anyone to stay in the ashrama rooms without prior permission of the ashrama supervisor.
If a student wants to leave the campus during the term, he or she should communicate with the College authorities and get
their approval before arranging the trip.
b.
c.
d.
e.
f.
g.
h.
2.
Public behaviour and dress code
a.
b.
c.
To use devotional attire in the temple and in the classroom (for women, gopi skirt and sari; for men kurta and dhoti, or
exceptionally, yogi pants). At other times, more casual attire may be acceptable if it is neat, clean, and modest (i.e. attire that
does not bring unnecessary attention to ones body).
For the men, to keep their hair short, if not shaven.
To develop an awareness of local customs and sensitivities, and to be careful not to offend neighbours and local villagers.
3.
Social interaction between men and women
The following guidelines have been established in order to maintain a healthy environment conducive to study and to spiritual life:
a.
b.
c.
d.
e.
Dealings between men and women should be courteous, respectful, and according to Vaishnava principles of behaviour.
Unless they are married or engaged when they come to the college, students in the first year commit themselves to not start a
relationship during the school year.
Students in the second and third years, especially if they are young, are encouraged to do the same. However, if they want to
pursue a serious relationship, they should approach a college tutor or authority before taking steps to start such a relationship.
Individual private meetings between men and women who are not married to each other is generally against Vaishnava
principles, and therefore unacceptable.
‘Hanging out’ between men and women without a specific healthy purpose (i.e. college assignments in a course or approved
spiritual and educational activities) is discouraged, as such behavior tends to degenerate, and thus prevent students from
following the abovementioned guidelines.
4.
Disciplinary action
a.
b.
Failure to follow any of these guidelines can be considered grounds for disciplinary action.
A student can be asked to leave the College if, after receiving a formal warning, he or she continues to not follow these
guidelines. A student who commits a very severe violation can be dismissed without a previous warning by the College
Administrative Council.
If a student is dismissed, tuition will not be reimbursed. Only the proportional fee for accommodation and prasada would be
returned.
c.
I state that I have carefully read these student guidelines and know the content thereof.
I hereby commit to follow them during my stay at Bhaktivedanta College.
Applicant's Signature:
Dates:
Bhaktivedanta College a.s.b.l., Petite Somme 10, 6940 Septon-Durbuy, Belgium
Email: [email protected] • Web: www.bhaktivedantacollege.com • Tel: +32 86 323277 • Fax: +32 86 322029
Bank: Dexia 068-2456949-63 • IBAN: BE40 0682 4569 4963 • BIC: GKCCBEBB
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