Application form for Introduction to Christian Mentoring Course

Dates: TBA

Online Course

Confidential – Please complete as fully as possible

– Step 1 of 6

1. PERSONAL AND CONTACT DETAILS

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Date of Birth *

Tel No. Day time

Tel No. Day Evening

Mobile No.

Email *

GDPR Agreement *

I consent to having this website store my submitted information so they can respond to my inquiry.

2. Course applied for *

OCNWM Endorsed Course (£350.00). Includes one assignment, which is explained on the course
Non-endorsed course (£250.00) You will get a Certificate of Attendance from DtN and there is no assignment

3. Mentoring Involvement Are you engaged in Christian Mentoring at present? *

(If ‘Yes’, then please complete the following details) Context

Name of person/organisation to whom you are responsible, and their work title (if applicable)

4. ADDITIONAL INFORMATION

Have you any health problems? If so, please give full details

Do you have any special needs in relation to physical, medical or educational support?

Do you have any dietary needs?

5. ACADEMIC AND VOCATIONAL QUALIFICATIONS

Please give details below of Secondary and Post-Secondary Education

6. DETAILS OF CHRISTIAN EXPERIENCE

How long have you been a committed Christian? Please give a brief account of your Christian experience. *

Details of the church of which you are a member *

Name of Minister/Pastor of your church *

How long have you been a member of this church? *

Where or from whom did you hear about this programme of study? *

7. REFERENCE

Reference's Name *

First

Last

Reference's Email *

Reference's Phone No. *

Please state in what capacity the referee has known you *

Once you have completed and submitted the Application form and we have taken up the reference we will email you to let you know that you have a place on the course. You will have one week to accept the place and pay the full fees by BACS. The payment for the course is non-refundable if you are unable to attend for any reason. If payment is not received within one week of being offered a place, then we cannot guarantee that there will be a place for you on the course.

8. DECLARATION: I confirm that by submitting this form that the information given on this form is true, complete and accurate and no information requested or other material information has been omitted. By signing this form you are accepting the Teams and Conditions below.