1. All parts of this application must be completed in detail. All portions (including reference forms) and application fee must be received in our Battambang office before we can consider you for training with UofN Battambang.
2. Please fill out all sections.
3. All references must be emailed to uofnbattambang@yahoo.com.
4. All international applicants are required to pay a $30 application fee. You can pay the fee through PayPal here.
Nanny will need to submit a separte student application. There is no application fee for nannies.
In case of emergency, I/we hereby agree to the performance of such treatment, including anesthesia
and surgery, as the attending doctor or physician may deem necessary.
I understand that payment of the required school tuition fees must be made in U.S. currency prior to or upon my arrival. Further, I agree to meet in a timely manner, prior to the completion of school, all expenses incurred during my involvement with Youth With A Mission and University of the Nations. If I am accepted by the University of the Nations, I will abide by the spirit, rules and schedule of the school.
Please answer all the questions below. Comment on all positive answers in the space below.
Have you ever had, or do you have now, any of the following?
FEMALES ONLY:
Have you ever had any of the following communicable diseases?
Have any of your immediate family members ever had any of the following?
Please select the year of each vaccination below.
Diptheria
Tetanus
Pertussis
Polio
Rubella
Mumps
Hepatitis A
Hepatitis B
I certify that all the information in this application is complete and accurate.
Please go back through the form and check to make sure that you have correctly answered all of the required fields.
When you submit this form, your answers cannot be changed.
Privacy: All answers are held securely. Youth With A Mission will not sell, exchange, or release your personal information (name, e-mail address, mailing address, etc.) to any third parties.