Reach Discipleship Program
Online application
First Name *
Your answer
Last Name *
Your answer
Nationality *
Your answer
Birthdate *
MM
/
DD
/
YYYY
Gender *
Phone Number *
Your answer
Email Address *
Your answer
Street (Number/Name) *
Your answer
City *
Your answer
Province/State *
Your answer
Postal/Zip Code *
Your answer
County *
Your answer
Additional Information
Emergency Contact *
Your answer
Emergency Contact Phone Number *
Your answer
Emergency Contact Relationship *
Your answer
Your profession or training *
Your answer
If student please indicate course/subjects *
Your answer
How were you influenced to apply to Reach Discipleship? *
Required
Relationships
Which of the following applies to you? *
If married, name of spouse
Your answer
Is your spouse applying to Reach Discipleship?
Health
Do you suffer from any disability which would limit you from doing practical duties *
Explain
Your answer
Have you had a nervous breakdown or mental illness at any time? *
Explain
Your answer
Have you suffered from, and had treatment for an eating disorder? *
Explain
Your answer
Do you have diabetes, epilepsy, blackouts, or other medical problems? *
Explain
Your answer
Do you require a special diet for medical reasons? *
Please list any food allergies
Your answer
Do you regularly require any prescribed medication? *
Please list:
Your answer
Do you have any food restrictions for non-medical reasons? Please describe.
Your answer
Have you had surgery within the past six months, or extended medical care? *
Have you regularly used tobacco, alcohol, or illicit drugs in the last year? *
Please provide details.
Your answer
Private or provincial medical plan number *
Your answer
NOTE: ALL STUDENTS ARE EXPECTED TO PROVIDE THEIR OWN MEDICAL COVERAGE.
Church affiliation
What local church do you attend? *
Your answer
Pastor's name (where none, name of Elder) *
Your answer
Church phone *
Your answer
Church address *
Your answer
References
Please provide the name, address, phone number, and email address of each person who will be completing your reference forms. These individuals will be contacted by email with reference forms from CQBC
Pastor/Church Official address and phone *
Your answer
Pastor/Church Official email address *
Your answer
Mentor/Associate Official email address *
Your answer
Mentor/Associate Official address and phone *
Your answer
Have you been convicted of a crime requiring jail term?If so, please specify. *
Your answer
If there is any additional information that we should be aware of regarding your personal background, we ask that you include this below. *
Your answer
*Please note that a criminal record check will be required. More info following acceptance.
Christian Experience
Have you accepted Jesus Christ as your Lord and Saviour? If yes, when? *
Your answer
Give a brief account of your conversion and discuss how the Lord has been working in your life recently. Also, please describe your relationship with Him today *
Your answer
What is your reason for wishing to attend Reach? *
Your answer
Have you received any previous Bible training at a Bible school or college? If yes, please describe the course. *
Your answer
Financial Payment Options
Bible School Tuition Information
STUDENTS ARE RESPONSIBLE FOR SUPPLYING THEIR OWN FINANCIAL SUPPORT.
Scholarships are not available from Capernwray Québec nor from Torchbearers Capernwray Canada.

TAX DEDUCTION
Tuition fees for Capernwray Québec may be claimed as a charitable donation for tax purposes in Canada. This may also apply in some of the U.S. states. Please check with your state. Receipts will be issued for tuition fees at the end of the year.

NOTE FOR NON-CANADIAN STUDENTS
Canada Immigration Officers will require proof of financial support at the Port of Entry into Canada.

2020 Reach Discipleship Program
Monday, April 20, 2020 – Friday, May 15, 2020
Cost: $1395
$1295 for Québec residents, returning students, & alumni
Cost includes all meals and accommodations.

Payment plan options will be provided upon completion of application.
Conditions of Enrolment
One of the reasons students are accepted at Capernwray Québec for Bible School is that they are committed to growing in the knowledge and love of the Lord Jesus. All guidelines begin with this premise. It is our effort to keep regulations to a minimum and to expect proper behaviour rather than legislating it.
When a group of people live together, there needs to be a clear understanding of practical guidelines in order to function as a body. The following are neither the means nor the end of true spirituality, but are practical guidelines to benefit the whole body of students and staff.

TIME TABLE
-All students are expected to dedicate themselves unreservedly to their studies and study periods and to conform willingly and promptly to the daily timetable.
-Punctuality and co-operation are essential for the smooth running and well-being of Bible School training and personal discipline.
-All students are expected to complete the course subject applied for, beginning on the first day and remaining to the closing date.

APPEARANCE
Please show moderation and modesty at all times, regardless of prevailing fashions in a permissive society.

In order not to distract or detract from each person's desire to study at Capernwray Quebec, no extreme piercings will be accepted during one's stay. Students are to refrain from obtaining any additional piercings or tattoos during their time at Capernwray Québec. Immodest clothing will also not be accepted, including ragged/slashed clothing as a style, short shorts or skirts, low cut tops, crop tops and overly tight clothing.

During your time at CQBC, Sundays will often involve attendance at a local congregation. Therefore, for all church services, as well as other special functions and some ministry outreaches, men and ladies are expected to wear semi-formal/business casual clothing including collared shirts for the men, pants or skirts for the ladies. Jeans are acceptable as long as they are free of holes, rips, and stains.

Men: We recommend wearing a belt as pants are not allowed to ride low enough that undergarments are revealed.

Women: In order to be honouring to God and to others living in community, and with a desire to showcase not only your outward but inner beauty, we request that your wardrobe consists of modest pieces. Shirts/dresses must cover your torso, and not contain any cut-outs. Skirts and dresses should reach one inch above the knee in length. Jeggings or leggings are to be treated as if they were pantyhose, and should be covered by dresses, skirts or shirts that reach your mid-thigh. Yoga pants are only permitted for exercising. Please also ensure that bra straps are not visible.

Swimwear for females should be one piece and swim shorts for males.

Please wear pyjamas/sleepwear in the dorms only.

ADDICTIONS
The use of tobacco, marijuana, recreational, and illegal drugs is strictly forbidden for legal, moral and spiritual reasons. It is expected that students who indulge in these will cease prior to registration and abstain throughout the course.

All students are required to abstain from drinking alcohol during their time at Capernwray Québec in order to respect their fellow students and community guidelines.

ACCOMMODATION
It is normally necessary to share bedrooms with a number of others in dormitory-style accommodation. Although age is taken into consideration, room assignments are made at the discretion of Capernwray Quebec staff, and generally, are not altered once established.
I have answered all questions in this application form accurately and to the best of my knowledge. I have read through, fully understand & agree to the above 'Conditions of Enrolment' and the Financial Payment Options sheet. I agree that if I breach these requirements, CQBC will have the right to suspend me or terminate this agreement without notice. I agree to unreservedly carry out my studies & duties in accordance with this agreement at all times to the best of my ability. I have also read through, fully understand & agree to the Bible School Privacy Policy which can be obtained by visiting our website (www.cqbc.ca).
I Agree *
Required
1 Corinthians 10:31 - Whatever you do... do all to the glory of God.
Registration Fee
A $35 registration fee is required for the processing of this application. This is in addition to the tuition and is non-refundable. This can be paid by E-Transfer, by mailing in a cheque, or by credit card.
Method of payment *
To pay by credit card please call our office - 1.450.882.1361 or toll free 1877.882.1361
BEFORE SUBMITTING YOUR APPLICATION, please confirm that you have completed the following: *
Required
Submit
Never submit passwords through Google Forms.
This form was created inside of Capernwray Quebec.