WEST COAST MISSIONS

670 Whiting Street, Grass Valley, CA 95945  (916) 202-5646 or (916) 541-9526  life@westcoastmissions.com  www.WestCoastMissions.com

Disciples Making Disciples

CHECKLIST OF APPLICATION MATERIALS

We want your application to West Coast Missions to go as smoothly as possible for you. This page is designed to give you an overview of
the various forms and other items that are involved in applying to WCM. Some are required for your application to be processed, while the
rest need to be submitted prior to the start of WCM.

Required for Acceptance into West Coast Missions

Application
The main application form. This should be completed and sent to West Coast Missions in January of the year you want to start WCM, or as
soon as possible after January. There is no application fee.
Supplemental Questions to Application
This is your chance to share your individual reasons for wanting to come to WCM and it helps us to get to know you a little prior to your
arrival in August. See application form for supplemental questions.
Recommendation Forms - # of recommendations to be determined. A minimum of 3 will be required.
You (the applicant) only need to fill out the beginning portion of each of these forms. You will then give the form to the person making a
recommendation, and they will send it directly to WCM. See the recommendation forms for detailed instructions.
Medical/Health Form (Physician’s visit required)
You will complete part of this form and take it with you to your physical exam, where your doctor will complete the rest. See the form for more
detailed instructions.
Transcript from high school / college
Please have your high school send an official transcript to WCM. If you have been to college, have your college send an official transcript as
well to: West Coast Missions, 670 Grass Valley, CA 95945

Other Items Needed for Your File:

Insurance Form (including a copy of your insurance card)
Keeps a record of your health insurance information and releases.
Support Form Lists your expected financial support while you are in WCM.

Passport: Please have your passport when you arrive in August. At registration, we will make a copy of it for your file.

Enrollment Fee: TBD

ADDITIONAL INFORMATION:
Interview:
One of the unique aspects about West Coast Missions is that we will conduct personal interviews with prospective students. After we've received your
application, recommendations, school transcripts and medical information, we will contact you to conduct a face-to-face interview. The interview may be
with the director and/or the assitant director. In some situations, the West Coast Missions adminstrative assistant may be present as well. But we will let
you know who's conducting your interview when we contact you.

Guidelines:
There will also be some guidelines that as a student you will have to follow, while in Grass Valley as well as while on the field. There may be some
additional guidelines that the missionary on the field may require, that while in Grass Valley we may not. These guidelines are not a means of control,
rather a way for us to create opportunites to see areas you may need to grow in. There are some guidelines in place that are as a practice of Biblical
principles, such as "be careful to do what is right in the eyes of everybody" (Romans 12:17) and "be careful, then how you live--not as unwise, but as wise"
(Ephesians 5:15). You will receive these guidelines at your personal interview. If you have questions before then, please don't hesitate to call or email the
director or assitant director at life@westcoastmission.com.

www.WestCoastMissions.com

Checklist Page
 Page 1 of 2
Application for Admission

WEST COAST MISSIONS

670 Whiting Street, Grass Valley, CA 95945  (916) 202-5646 or (916) 541-9526  life@westcoastmissions.com  www.WestCoastMissions.com

Disciples Making Disciples

FOR OFFICE USE ONLY:

Date received: Application Medical Recommendations Guidelines

Date accepted: Questions Transcripts Support Insurance Passport

Dear Applicant,

We've been praying for God to put the desires into the hearts of young men and women who want to seek and serve God. We're thankful to God that you're considering West Coast Missions at this
time in your life. We hope and pray that West Coast Missions will be a life changing experience for you, one that promotes a lifelong faithful discipleship to Christ. We are seeking students who desire
to grow in their relationship with God, in knowledge of His Word, and who desire to share this with others. West Coast Missions requires a high level of commitment, hard work and moral character.
And because West Coast Missions will be so intense, we require students to raise support rather than working at a traditional job for income. If this describes you, please fill out this application in it's
entirety with honesty and integrity. We look forward to this journey together with you!

INTRODUCTORY INFORMATION: All information on this form will remain confidential.

(Please attach a recent photo of yourself)

Name
as it appears on legal Last First Middle Preferred Nickname
documents, (birth certificates,
social security card, driver's
license, etc)
Date of Birth Social Security Number

Male Single Divorced

STATUS:
Female Engaged Married

Street City State Zip

Contact Information
Home Phone # Cell # Email

CHURCH BACKGROUND
Have you been baptized? Yes No If yes, when?

Briefly describe your conversion experience:

Name of Congregation

Home Congregation
Information Street City State Zip

Church Phone Number

Do you attend regularly: Yes No How long have you attended there?

Preacher:
Name Contact Number

Elders (if your congregation doesn't have elders, please list a couple of leading men)

Name Contact Number

Name Contact Number

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Application Form
Application for Admission page 2 of 2 West Coast Missions
FAMILY BACKGROUND
How many siblings do you have? Ages?

Are your parents members of the Church of Christ? Yes No

If yes, for how long?

Are any of your siblings members of the church? Yes No

If yes, for how long?

Do your parents approve of you working on the mission field? Yes No

Describe your present relationship with your immediate family:

PERSONAL HISTORY
Have you ever been on a mission trip? Yes No

If yes:
Dates Location Purpose
MISSIONS
EXPERIENCE
Dates Location Purpose

Dates Location Purpose

The answers to the following questions require honesty and integrity and will not affect, influence or determine your acceptance into the West Coast Missions program.

Have you ever: If yes, please briefly explain in detail (attach a separate sheet if necessary)
OTHER Been expelled from school? Yes No
PERSONAL Served time in a detention center? Yes No
HISTORY Been convicted of a crime? Yes No
Used illegal drugs? Yes No

In the past 2 years have you: If yes, please briefly explain in detail (attach a separate sheet if necessary)
Used tobacco? Yes No
Used alcohol? Yes No
Been fired from work? Yes No
Been sexually active? Yes No

On a separate sheet, answer the following questions using brief, but detailed responses.
Use as much space/pages as necessary keeping your responses concise; however your responses must be typed, 1.5 spaced, 12 size font Times New Roman or
Arial, 1” margins required.

1. Why do you want to come to West Coast Missions?

2. Discuss a time when your integrity was challenged. How did you handle it?
3. Describe some areas you'd like to see yourself grow in. What situations do you see occurring that might encourage this growth?
4. What are your goals: while a student at West Coast Missions? In life?
5. Describe a time when someone told you something which you disagreed with that decision. What was your response? Would you have responded
differently in the future? If yes, how so?
6. In what situation would you determine honesty would be inappropriate?
7. When does the real you within you really come alive? What are your passions that expand your mind and energize your emotions?
8. What in your past have had to overcome with God's help?

www.WestCoastMissions.com
Application Form
 Page 1 of 2
Recommendation from a Church Member

WEST COAST MISSIONS

670 Whiting Street, Grass Valley, CA 95945  (916) 202-5646 or (916) 541-9526  life@westcoastmissions.com  www.WestCoastMissions.com
www.WestCoastMissions.com

Applicant: Please fill in your name and phone number below, then give this form to the person from whom you're requesting the recommendation.
Do not fill out the rest of this form. You will need a minimum of 3 recommendations to supplement your application.
Church Member: Please fill out this form to the best of your knowledge and submit it to the West Coast Missions office. We appreciate all thorough and honest
information you can provide to assist us in your perception of the applicant. Please mail this form directly to WCM. Please do not hand the completed form back to
the applicant.

INTRODUCTORY INFORMATION: All information on this form will remain confidential from the applicant.
Applicant
Applicant Name

Church
Member Church Member Name (reference person filling out this form) Daytime Contact Number

Info
Address City State Zip

West Coast Missions is an intense 2 year apprentice missionary training program. Because of the nature of this program, we require a high level of integrity, commitment, a
willing, serving and humble heart from each student. The information you provide will remain confidential and is valuable in our efforts to prepare each student for a life-changing
experience for faithful discipleship of Christ.

APPLICANT'S PERSONAL HISTORY

How long have you known the applicant?

If less then 6 months, do you know someone we can contact to assist with this recommendation?

Name Phone Number

How well do you know the applicant? Only by name/face Casually

Fairly well Very Well

How did you meet the applicant?

GENERAL BACKGROUND AND OTHER INFORMATION

Please comment on the applicant's family and social background as well as include any information you consider relevant to us regarding his/her current character and past
background. Please include any knowledge you may have regarding previous substance abuse history and dating history that you think is relevant to help us understand the
applicant better.

Please describe the applicant's church attendance and participation:

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Recommendation Form
Church Member Character Reference continued page 2 of 2 West Coast Missions
CHARACTER & SKILLS (please use another page if necessary, keeping responses as concise as possible)
What leadership and servant hood qualities do you see in this person?

What do you perceive are the applicant’s strengths?

What weaknesses have you observed that might detract from applicant’s ability to serve on a team?

How well does the applicant seem to function under stress?

Please summarize how you feel the applicant would perform working on a team and in a different culture?

Is this person's walk with Christ evident to an outside observer? 

(if no, please explain what you notice that gives you this impression)

Please rate the following attributes for the applicant:

1- poor 2-average 3-amazing
Please feel free to add comments you think are necessary to further explain your rating. If you are unsure or don't know, please indicate so in the comments section for that attribute.

Comments: Comments:
Adaptability/
Flexibility 1 2 3 Self-Confidence 1 2 3

Helpfulness 1 2 3 Relates to New People 1 2 3

Dependability/
Responsibility 1 2 3 Maintains Friendships 1 2 3

Maturity 1 2 3 Being an example 1 2 3

Attitude toward
Authority 1 2 3 Active at church 1 2 3

Leadership Ability 1 2 3 Listening 1 2 3

Emotional Stability 1 2 3 Humility 1 2 3

Positive Attitude 1 2 3 Personal Hygiene 1 2 3

Honesty 1 2 3 Physical Condition 1 2 3

Time Management 1 2 3 Personable 1 2 3

Please take the time to carefully assess the applicant in each of the following areas.
Circle or highlight any traits that are regularly observed in the applicant.

Holds a grudge Impatient Prejudiced Eager to help others Patient

Procrastinates Intolerant Works too hard Seeks to understand Generous

Arrogant Argumentative Always has a crisis Jumps to conclusions Kind

Easily Discouraged Overly critical Resistant Seems teachable Friendly

Easily Embarrassed Domineering/Bossy Doesn't take correction well Center of attention Confident

Easily Offended Flirty Involved in constant romantic relationships Exaggerates the truth Hospitable

Lazy Can’t take jokes Struggles w/financial integrity Takes initiative Organized

Low self-esteem Depressed Lacks spiritual integrity Willing to try new things Evangelistic

Moody Irritable/Quick-tempered Often nervous Peacemaker Eager to learn

Rebellious Worries a lot Tends to isolate self Admits when wrong Polite

Please add any other characteristics you notice in the applicant, that are not listed above:

To the best of your knowledge is the applicant is the applicant's desire to come to WCM influenced by a desire to escape a difficult situation, such as:
Family Problems Troubled Romance
Financial Problems Other
None to my knowledge
Overall your recommendation would be:
Strongly Recommend Recommend with some reservations (as noted above or listed here)

Recommend Not Recommend

Thank you for your time. We appreciate your input. Please know that we make our decision based on a variety of informational sources.
Your reference is just one resource to aid in our decision making process. Thank you!

Please mail this form to: West Coast Missions, 670 Whiting Street, Grass Valley, CA 95945 DO NOT GIVE THE FORM BACK TO THE APPLICANT! Please mail it directly to the address
on this form. If you have additional information that you would like to share please don't hesitate to include that information on a separate page or you may call either of the phone
numbers on the top of page one. Thank you for your help!

www.WestCoastMissions.com
Recommendation Form