Student Application for Admission
13470 Fort Rd. NW, Edmonton, AB T5A 1C5
(780) 475-1647
Student Application for Admission
Personal Information (Please Print Neatly)
Legal Name: ___________________________________________________________________________________________________
Last
First/Middle
Preferred First Name
Address ____________________________________________________________________________________________________________
Street
City
Province
Postal Code
Country _________________________________________________________ Phone (______) __________________________________
Age ______________ Birthdate ___________________________ Present Occupation ____________________________________
Have you ever been convicted of a crime?
________ Yes
________ No
If yes, please explain _________________________________________________________________________________________________
Emergency Information (Father/Mother or Guardian)
Name
Address
Home Phone:
Work Phone:
Cell Phone:
Email:
Relationship Guidelines
Master’s Commission Edmonton has a no dating policy for the entire year of training. These guidelines
are to protect and strengthen the students’ relationship with the Lord and to protect their integrity as
disciples. Please read the Relationship Guidelines in the Student Handbook.
1. Are you presently dating or romantically interested in someone?
2. I have read the Relationship Guidelines in the Student Handbook.
3. I agree to the no dating policy for the duration of
Master’s Commission Edmonton program:
Tuition #1
Tuition #2
Tuition #3
_____ Yes _____ No Initial: _____
_____ Yes _____No Initial: _____
Payment Description and Due Dates
Fee
Application
_____ Yes _____ No
Description and Due Date
The amount is due upon submitting this
application and is non-refundable.
Due: Prior to July 31, 2014. This amount is nonrefundable and allocated to purchasing the
resources for the year. If you would prefer
available textbooks via Amazon Kindle, please
provide the email address for your Amazon
account.
Due: Prior to Orientation. Students who bring a
vehicle for carpool purposes may receive up to a
$500.00 deduction from the program fee. Please
see Student Handbook for more details.
Due: Upon return from Christmas Break
Total Tuition
Cost
$100
$600
$4000
$600
$5300
Please contact our office regarding questions about payment plans and options.
Bring Your Own Device Information
Master’s Commission Edmonton will be providing iPads to students for note taking and book reading
purposes. Students who have either a tablet or laptop they would prefer to use must meet specific
requirements. Students providing their own device may receive a credit to their Tuition. Devices must be
able to read and edit PDF files, open Kindle books and send emails.
Would you like to bring your own device? _____ No _____ Yes
Do you have a gshare Account? _____ No _____ Yes
If yes, what type of device? ___________________
If yes, email address of account? ___________________
Vehicle Information
Do you have your driver’s license? _____ Yes
______ No If Yes, what class of license? ________________________
Are you interested in bringing a vehicle for carpool purposes?
_____ Yes
_____ No
Make: _________________________________________ Model: ____________________________________ Year: ____________________
Number of Working Seatbelts: ______________________ Vehicle Liability ($2 million) _____ Yes ______ No
I understand that if my vehicle is not selected for the purposes of carpool, I will not be receiving the
credit for tuition costs. I also understand that it will be my responsibility to keep my vehicle in working
order throughout the year. Initial: ______________
Financial Resources
List of debts, loans, or payments that you presently have: _______________________________________________________
_________________________________________________________________________________________________________________________
Present total indebtedness $ ______________________________________ Monthly Payment $ __________________________
Will your debts be paid off by the start of Master’s Commission Edmonton?
_____ Yes
Will you have the total amount of the program’s costs by the required dates? _____ Yes
_____ No
_____ No
If no, what is your plan to pay the overall cost of Master’s Commission Edmonton? _________________________
________________________________________________________________________________________________________________________
Please sign below that you have read and agree to the terms of the Financial Information in the Student
Handbook.
Signature of Applicant
Date
Signature of Parent or Guardian (if student is a minor)
Date
Academic Background
High School Attended _____________________________________________ City _________________________ Province ________
Graduation Date _______________________________ or date of GED completion _______________________________________
Below, please list any other colleges, universities or schools you have attended.
Academic Institution
Location
Dates Attended
Diploma/Degree Earned
Health
Do you have any physical limitation(s), learning disability(s) or pre-existing medical condition(s)?
_____ Yes
_____ No
Please describe _______________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
Are you currently taking any medication?
_____ Yes
_____ No
Please describe _______________________________________________________________________________________________________
Have you ever struggled with or been treated for a mental disorder (anxiety, depression, bipolar, eating
disorder, etc.)?
______ Yes
______ No
(If so, please provide more details on a separate sheet of paper including description of disorder, any
medication taken and whether you are currently taking these medications).
Describe your general health/ Do you have any allergies? _______________________________________________________
Have you ever used illegal drugs? _____ Yes
Do you smoke tobacco?
Do you drink alcohol?
_____ Yes
_____ Yes
_____ No
_____ No
_____ No
If yes, date of last use: ______________________
If yes, date of last use: ______________________
If yes, date of last use: ______________________
Religious Information
Home Church
Mailing Address
Pastor ______________________________________________________ Phone __________________________________________________
Address
When did you accept Christ as your Savior? _______________________________________________________________________
Below, please indicate what kinds of Christian service you have participated in.
Preaching
Youth
Children’s Work
Missionary Work
Evangelism
Other (Specify)
Check How Long?
____
__________________________
Worship Leading
____
__________________________
Piano
____
____
____
____
__________________________
__________________________
__________________________
__________________________
Vocal Group
Check How Long?
____ ________________________
____ ________________________
____ ________________________
Stringed Instruments ____ ________________________
Other (Specify)
____ ________________________
Please read the Fort Road Victory Church Statement of Faith on the church website (www.frvc.ca)
and respond to the following questions:
Insofar as you have formed an opinion, do you find yourself in general agreement with our Statement of
Faith? _________________________________________________________________________________________________________________
Are there any areas of disagreement? ______________________ If so, please state which ___________________________
I promise that, if accepted to Master’s Commission Edmonton, I will at all times conduct myself as a
Christian, faithfully and diligently apply myself to the studies required by the program, promptly meet all
financial and other obligations, and carefully obey the rules and regulations as set forth by Fort Road
Victory Church leadership and the leadership of Master’s Commission Edmonton.
Signature _____________________________________________________________________________ Date _________________________
Pastoral Reference
Name of Applicant
(to be completed by your current pastor)
Last
First
Middle
To the Applicant: Print your name on the line above and give this form to your pastor. If your
father/mother is your pastor, please refer the form to another minister or leader in your church. If a
person other than your pastor or assistant pastor completes the form, an explanation from you should be
sent to the directors of Master’s Commission Edmonton.
To the Pastor: Each applicant for admission to Master’s Commission Edmonton must submit a
recommendation from his or her pastor or substitute as mentioned above. Serious consideration is given
to the recommendation, and, therefore we request that you complete the form carefully and candidly.
Because we expect straightforward comments, we will handle this recommendation with the strictest
confidence.
Following to be completed by the pastor:
1. How long have you known the applicant? ______________________________________________________________
How long has he/she been in your church? ____________________________________________________________
2. How well do you know him/her? (check on the following scale)
_____ Casually – just by name and sight
_____ Have had few personal contacts
_____ Fairly well – have had a number of personal contacts
_____ Have had a very close pastoral relationship
3. To the best of your knowledge, has the applicant made a personal commitment to Jesus Christ?
_____ Yes ____ No _____ I don’t know
Comments ____________________________________________________________________________________________________
_________________________________________________________________________________________________________________
4. To what extent is the applicant engaged in the activities of your church (check one):
_____ Is irregular in attendance – little interest in activities
_____ Seldom participates in activities, although regularly attends
_____ Is cooperative and usually willing to help in the various activities of the church
_____ Enthusiastically engages in the activities for his/her age
5. In what forms of Christian service has the applicant been regularly active (Sunday School, Youth
Group, Choir, Outreach, etc.
6. If the applicant does not participate, do you know why?
7. In comparison with other young people you know, how would you rate this person in the
following areas:
Superior
Above Average
Average
Below Average
Leadership
Responsibility
Loyalty to Church
Commitment
8. In your opinion, does this applicant possess any outstanding abilities? ________________________________
Please describe: ______________________________________________________________________________________________
9. In your estimation, this applicant’s spiritual influence on his/her classmates will be…
(please circle one)
Strengthening
Neutral
Adverse
I don’t know
10. Please circle the terms which best describe the applicant’s attitude toward the church:
Warmhearted
Devoted
Enthusiastic
Critical
Contemptuous
Rebellious
Antagonistic
Loving
Passive
Grateful
Apathetic
Sympathetic
Bitter
Tolerant
Respectful
Other: ___________________________________________________________________________________________________________
11. Would you place full confidence in his/her integrity?
___________________________________________________________________________________________________
Comments: _________________________________________________________________________________________________
12. To your knowledge, does the applicant smoke, drink, or have they abused drugs? _________________
13. Are there personality traits, which hinder this applicant in his/her relationship with others? ______
______________________________________________________________________________________________________________
14. Please describe home factors of which you are aware, which might affect the applicant’s success at
Master’s Commission Edmonton. We are interested in the positive as well as the negative factors.
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
15. Has the applicant discussed with you the concept of a discipleship program? _____ Yes
_____ No
Do you fully approve of the applicant coming to Master’s Commission Edmonton? _____ Yes _____ No
Comments ____________________________________________________________________________________________________
_________________________________________________________________________________________________________________
Signature ______________________________________________ Date __________________________
Print Name ___________________________________________________________________________________________________________
Last
First
Middle
Position __________________________________________________ Phone (_________) _________________________________________
Church Name_________________________________________________________________________________________________________
Address_______________________________________________________________________________________________________________
Mailing Instructions
Please mail/fax this form to:
Master’s Commission Edmonton
13470 Fort Rd. NW
Edmonton, AB T5A 1C5
Fax: (780) 472-1383
Questions? Call 780-475-1647
Parental or Guardian Reference
(to be filled out if the student is 18 or under).
Name of Applicant
Last
First
Middle
Instructions: The person named above is applying for admission to Master’s Commission Edmonton.
We support the authority of parents in students’ lives, and desire your cooperation in completing this
form. All information will be held in strict confidence. Your reference, along with other required
references, will help us in our decision as to whether to accept this student’s application or not
Family Information
1. Mr. ___________________________________________________ Mrs. ___________________________________________________
2. What relationship does that applicant have to you? _____ Son
_____ Daughter
_____ Other
If other, please explain relationship________________________________________________________________________
_________________________________________________________________________________________________________________
3. Has the applicant discussed or consulted with you concerning his/her interest in attending
Master’s Commission? ______ Yes
_____ No
4. Has the applicant had any serious problems in submitting to parental or other authority?
_____ Yes
_____ No
Comments ____________________________________________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
5. What do you understand to be the motive for the applicant wanting to attend Master’s
Commission Edmonton?_____________________________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
6. Has the applicant read through and discussed with you the guidelines for their year of Master’s
Commission Edmonton? _____ Yes _____ No
7. What was his/her general attitude to these guidelines? _________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
8. Understanding our desire that there be no conflict with parental authority, would you be
supportive of these guidelines?
_____ Yes
_____ No
Comments____________________________________________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
Religious Information
Church presently attending _________________________________________________________________________________________
Pastor’s Name ___________________________________________________ Phone (_______) ___________________________________
Address _______________________________________________________________________________________________________________
Approval
Do you fully approve of the applicant coming to Master’s Commission Edmonton?
_____ Yes
_____ No
Please feel free to add further comments__________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
Signature ___________________________________________ Date _____________________________
Mailing Instructions
Please mail/fax this form to:
Master’s Commission Edmonton
13470 Fort Rd. NW
Edmonton, AB T5A 1C5
Fax: (780) 472-1383
Questions? Call 780-475-1647
Mentor’s Reference
(to be filled out by youth/young adult leader, teacher, counselor, etc.)
Name of Applicant
Last
First
Middle
The personal named above is applying for admission to Master’s Commission Edmonton. Your
cooperation in completing this Mentor’s Reference form will be greatly appreciated. All information will
be held in strict confidence.
Please check the following:
Superior
Above Average
Average
Below Average
Inferior
Academic Ability
Initiative/ Motivation
Concern for Others
Leadership Ability
Social Appearance
Personal Appearance
Moral Standards
Cooperation/ Submission
Reliability
Response to Correction
1. Do you believe the applicant is a born-again Christian? _____________ What evidence have you seen
in his/her daily life? _________________________________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
2. In what form of Christian work has the applicant engaged, and with what success? Give a full
statement as possible.
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
3. Comment on the family and social background of the applicant.
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
4. To your knowledge does the applicant participate in any of the following?
_____ Drug Usage
_____ Smoking
_____ Drinking
_____ N/A
5. Have you had any occasion to question his/her moral character? _____________________________________
6. What is the general physical condition of applicant? _____________________________________________________
7. Does he/she have any mental or physical disabilities? ___________________________________________________
8. To your knowledge, is the applicant prompt in paying debts? ___________________________________________
9. Does the applicant, in your judgment, display fitness and aptitude for a discipleship program?
_________________________________________________________________________________________________________________
10. In your opinion, is the applicant emotionally stable? _____________________________________________________
11. Would you unhesitatingly recommend the applicant’s acceptance to Master’s Commission
Edmonton?
______ Yes
_____ No
Comments ____________________________________________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
12. These observations are based on an acquaintance over a period of __________________ years.
Comments ____________________________________________________________________________________________________
_________________________________________________________________________________________________________________
Signature ___________________________________________ Date _____________________________
Print Name ___________________________________________________________________________________________________________
Address_______________________________________________________________________________________________________________
Phone (_________) _________________________________________
Mailing Instructions
Please mail/fax this form to:
Master’s Commission Edmonton
13470 Fort Rd. NW, Edmonton, AB T5A 1C5
fax: (780) 472-1383
Questions? Call 780-475-1647
Biographical Statement (to be completed by applicant)
Instructions: Please write a short testimony statement to include the following
information:
[A] Salvation Experience [B] Water Baptism [C] Baptism of the Holy Spirit [D] Goals and Desires for the
Future [E] Why you wish to attend Master’s Commission Edmonton
(minimum of 250, maximum of 500 words - please use the space provided below or type on a separate
piece of paper)
Name of Applicant ______________________________________________ Date ________________
Last
First
Middle
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________
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*If additional space is needed for answers, please use another sheet of paper.
Fund-raising Policy
The $5300.00 tuition covers a portion of the cost of the entire year per student. Master’s Commission
Edmonton has committed to raise the remainder of the budget through fund-raising. Staff and students
are required to be involved in the fund-raising events throughout the year.
Dispute Resolution and Dismissal Policy
Master’s Commission Edmonton Staff is committed to resolving all disputes that may arise within our
student body or students and houseparents in a Biblical manner. This commitment is based on God’s
command that Christians should strive earnestly to live at peace with one another (Matthew 5:9 and
Romans 12:18). We will always seek resolution with the students in all matters, and consultation with
students, staff, parents, and houseparents will always be our first and utmost priority.
In the event that a student fails to honour their commitment to the Student Handbook, action will be
taken according to the Biblical principles outlines in Matthew 18:15-17. Our first step will be to address
the student and their action one on one. If at this point the student does not show signs of a repentant
heart, Master’s Commission Edmonton leadership and Fort Road Victory Church leadership will address
the student’s attitude and actions. If all these steps have been taken and the student is still unresponsive
to the correction of Master’s Commission Edmonton and Fort Road Victory Church leadership, as a last
resort, dismissal may result. We will, however, give every opportunity for the student to remain in the
program. The option of a probation period may also help to resolve indifferences. Our commitment is to
Biblically resolve any problems that may arise.
Signature of Applicant
Date
Signature of Parent or Guardian (if student is a minor)
Date
Authorization for Treatment of a Minor
Dear Health Care provider:
If I am unable to be reached to provide consent for medical care, I, the undersigned parent or legal
guardian of
__________________________________________________________________________________________________________________,
a minor, authorize the houseparents designed by Master’s Commission Edmonton or the leadership of
Master’s Commission Edmonton to consent in any emergency situation to any medical or surgical
procedure or hospital care required for the above minor. Hospital care may include any laboratory tests,
X-ray examinations and anesthetic required. All medical care must be acknowledged as necessary by and
performed under the supervision of a physician licensed to practice medicine in the province or nation in
which the student lives or to which the student has traveled.
In my absence, my child may be released to the houseparents or leaders designed by Master’s
Commission Edmonton following completion of treatment.
Signature of Parent or Guardian
Date
Signature of Applicant
Date
Check List
Student
Application for
Admission
Signed Financial
Discloser
Academic
Background
Biographical
Statement
Signed
Policies
Signed Treatment
of Minor
Parent
Reference
Pastoral
Reference
Personal
Reference
Copy of ID
(Passport, Medical
Policy, Diver’s
License)
Criminal Record
Check
Picture
Application
Fee
Textbook
Fee
Diver’s License
(Learners, N or Full
license)
Allergies
Bringing a Vehicle
Form (if applicable)
Name: _______________________________________
Home Phone Number: _____________________
Cell Phone Number: ________________________
In
Missing
Date Handed In