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BASIC INFORMATION






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European Residents
We collect personal information to be used in evaluating all applicants to our program. Due to the adventurous and religious nature of our program, this personal information may include: contact information, medical history information, school information, personal history, and personal beliefs, among other things. If you do not feel comfortable filling out this application and freely providing this information, please contact Rachelle at rcw@cafe1040.com


Please also note that at any time during the application process you may request for your information to be removed from our system!  If you are not accepted to our program, your application data will be deleted from our system after 4 years.




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PROGRAM



HOW DID YOU HEAR ABOUT US?














ADDRESS
Best Current Mailing Address






Permanent Address - if different from above






ADDRESS
Best Current Mailing Address







EDUCATION









WELLNESS






CHRISTIANITY



CHURCH




CHRISTIAN THEOLOGY







MISSIONS


ACTIVE MINISTRY





MARITAL STATUS


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LIFE STAGE


PARENT INFORMATION
*We will not contact your parents without your permission first.









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REFERENCES

REFERENCE 1

We may call a reference during your process to help us determine how to best serve you. This is a person who you consider a personal spiritual mentor, discipler, or pastor. 





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REFERENCE 2




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