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TBS Application [PRIVATE]
TBS Application [PRIVATE]
Media Department
2021-11-02T16:02:55-04:00
1
Student Information
2
Family Information
3
Additional Information
4
Parent / Guardian Recommendation
5
Transportation Release
6
Medical Release
7
Signatures and Payment
*This application should be completed with the applicant and the applicants parent(s) - parent will need to sign off release forms, provide recommendations and provide the teens' medical insurance information.
I certify that I am a current member of Living Stream Church.
*
Non-Living Stream Member applications will not be valid and will be refunded, your application will need to be re-submitted November 1st. There will be a loss in the application fee.
Yes, I certify
Hidden
Apps closed?
Yes
No
Hidden
Account Type
Hidden
Page applied through
Hidden
TBS Year Applying To
Hidden
Acceptance Status
Application Received
N/A
Application Received
Application Under Review
Application Accepted
Waitlisted
Application Declined
Withdrew Application
Hidden
Tuition Status Update:
Downpayment Paid
Tuition Paid in Full
Under Payment Plan
Payment Not Received
Partial Payment Received
Balance Paid After Discount Applied
Student Name
*
Mr.
Ms.
Prefix
First
Last
Date of Birth
*
MM slash DD slash YYYY
How old will you be upon the start of TBS?
*
Please Select
14-15
16-17
Please upload proof of age
*
ex: birth certificate, permit, license, school report card, any government issued ID that shows your birthdate
Drop files here or
Select files
Accepted file types: jpg, jpeg, gif, heif, heic, png, pdf, Max. file size: 15 MB, Max. files: 1.
Gender
*
Male
Female
Address
*
Street Address
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Swaziland)
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Réunion
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen Islands
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Student's Mobile Phone
*
Student's Email
*
Enter Email
Confirm Email
Student's Instagram Handle
Have you attended this program before?
*
No
Yes
Primary Language
*
English
Russian
Ukrainian
Other
Other Language
*
Residency
*
USA
Other Country
Other Residency
*
Upload Portrait Photo
*
Must be a portrait style photo of just you (max 10mb)(only jpg, png)
Drop files here or
Select files
Accepted file types: jpg, jpeg, gif, heif, heic, png, Max. file size: 15 MB, Max. files: 2.
T-Shirt Size
*
Please Select
XS
S
M
L
XL
XXL
Do you have any physical disabilities, serious illnesses, or allergies?
*
No
Yes
If yes, please explain
*
Thank you for your interest! Unfortunately, due to high demand, we have reached capacity and the applications for all girls and 14-15 year old boys is now closed.
Father/Guardian's Information
Name
*
First
Last
Address
*
Same as student
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Swaziland)
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Réunion
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen Islands
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Father's Mobile Phone
*
Father's Email
*
Enter Email
Confirm Email
Mother/Guardian's Information
Name
*
First
Last
Address
*
Same as student
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Swaziland)
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Réunion
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen Islands
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Mother's Mobile Phone
*
Mother's Email
*
Enter Email
Confirm Email
Name of Church
*
Denomination
*
Pastor's Name
*
First
Last
Church Phone Number
*
Youth/Teen Leader Name
*
First
Last
Youth/Teen Leader Phone
*
Background Information
Have you had an abortion?
*
No
Yes
Have you been arrested?
*
No
Yes
If Yes, Please Explain
*
Have you been convicted?
*
No
Yes
If Yes, Please Explain
*
In the past 12 months, have you experienced:
*
Drugs/Illegal Substances
Tobacco
Occult/Witchcraft
Abuse
Homosexuality
Pornography
Sexual Activity
Eating Disorder
Severe Depression
Self-Inflicted Harm
Alcohol Consumption
Addiction to videogames
None of the above
Please select all that apply
If you marked "Yes" to any of the above, please explain when and the duration
*
Other:
What biblical topics are you most interested in?
*
List some skills and talents that you have
*
Why would you like to attend Teens Bible School?
*
I certify that the following portion is being filled out by a parent/guarding of the applicant.
*
Yes, I certify
Parent/Guardian's Recommendation
*
Please describe your teen's good qualities & capabilities
*
Please indicate any areas that your teen should improve in
*
Parent/Guardian's Name
*
First
Last
Parent/Guardian's Signature
*
By signing this form, I hereby release Teens Bible School, as well as its directors, officers, administrators, employees, or other agents from all liability or damages for any and all injury arising from the negligence of any of the above while traveling to this activity via private transportation and/or charter bus.
Name of Location Visiting: SMBS
Date: June 18, 2022 - July 16, 2022
Address: 2016 Anniston Road Jacksonville, FL 32246
Teens Bible School must have this signed form in their possession prior to the date of the specified activity.
Student Signature
*
Parent/Guardian's Signature
*
I. IF AND WHEN THE BEHAVIOR OF MY CHILD(REN) BECOMES TOO DISTRACTING FOR THE OTHERS ON OR THE DRIVER OF THE CHARTER BUS AND/OR VAN, I ACKNOWLEDGE THAT SHE OR HE WILL BE ASKED TO FIND OTHER TRANSPORTATION TO THE CHURCH AND/OR LOCATION OF ACTIVITY.
II. WE, THE UNDERSIGNED, HAVE READ THIS RELEASE AND UNDERSTAND ALL ITS TERMS AND EXECUTE IT VOLUNTARILY AND WITH FULL KNOWLEDGE OF ITS SIGNIFICANCE. WE UNDERSTAND THAT THERE IS NO MEDICAL INSURANCE PROVIDED BY THE TEENS BIBLE SCHOOL OR THE SLAVIC MISSIONARY BIBLE SCHOOL.
Student Signature
*
Parent/Guardian's Signature
*
Teens Bible School Medical Release Form
Student's Name
*
First
Last
In the event of a medical emergency, I give permission to School Personnel to authorize whatever treatment is necessary and I will accept liability for payment of any bills related to the treatment.
Effective Dates: June 18, 2022 - July 16, 2022
I DO NOT have medical insurance
Insurance Company
*
Policy Number
*
Please list any medical problems or special needs (include medication).
Medications can only be issued by School Personnel. A Parent Permission for Medication Administration Form must be filled out by the parent (available by contacting the TBS Office at (888) 308-7627).
Parent/Guardian's Signature
*
Parent/Guardian's Name
*
First
Last
In case of emergency:
Contact Person
*
Relation
*
Home Phone
Work Phone
Cell Phone
*
Other Emergency Number
*
TBS Tuition Payment
*
Deposit ($400)
TBS Application Fee
*
Price:
TBS Housing Fee
*
Price:
Processing Fee (3%)
*
Price:
$0.00
LSC Member Discount
*
Price:
If you just pay the deposit at this time, the remaining balance of $700 must be paid by June 10th, 2022
Billing Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Swaziland)
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Réunion
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen Islands
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Credit Card
*
Card Details
Cardholder Name
Credit Card
*
American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number
Month
01
02
03
04
05
06
07
08
09
10
11
12
Year
2023
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
Expiration Date
Security Code
Cardholder Name
Scholarship Code
Total
$0.00
I understand that if I have applied to TBS and can no longer attend or my circumstances have changed, the refund of the deposit ($400.00) will NOT be returned in accordance to our REFUND POLICY. In the event that my application is DENIED for various reasons, I will receive a refund of the deposit ($400.00). Application Fee and Processing Fee is non-refundable.
*
Yes, I understand
I have reviewed and agree to obey all rules and schedules of Teens Bible School.
*
Yes, I have reviewed and agree
I certify that all of the information and statements on this application are complete and accurate.
*
You will be contacted regarding your application, using this information
Yes, I certify
Student Signature
*
Are you a human?
Please check all the information above to be sure it is correct.
Note: Be patient while your credit card is validated.
Submitting your Registration may take several seconds. Please wait for the process to complete.
Click 'Submit' only once and do not click the 'Back' or 'Refresh' buttons on your browser.
Please wait for your confirmation page to display.
Again, thank you for your patience.
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