DLI # 0213392219317 Please Use a Desktop Computer to Fill Out Application CANADIAN STUDENT APPLICATION FORM Name: Address: Date of Birth: *Sex: Telephone: Email: Birthplace: Occupation: *Marital Status: Single Married Separated Divorced Remarried Spouse Name (If Applicable):
Note: If your spouse plans to take classes at LWBC, please have him/her complete a separate application. _______________________________________________________________________________________________________ NEXT OF KIN
In case of medical or other emergency, indicate name and telephone number of person to contact: Name: Telephone: Relationship: _______________________________________________________________________________________________________ SPIRITUAL INFORMATION Home Church: Address: Head Pastor: Denomination: _______________________________________________________________________________________________________ MEDICAL INFORMATION Provincial Health Card Number: Province: *Please list any medications that you must take on a regular basis: *Have you ever received treatment for a social or a mental disorder? If so, please explain. *Please list any conditions or illnesses that you may have had. We recommend that you have a medical checkup prior to arriving as a student at the Living
Word Bible College. Please notify us of any medical condition which may interfere with your
Application Fee (Canadian Students) $25.00
Application Fee (International Students) $100.00
SEMESTER 1 SEMESTER 2
Tuition Fee & Room and Board $ 5000.00 $ 3000.00
Note: International Students arriving with Sponsored financial support - Tuition &
Room/Board fees must be paid in full (entire year) by the first day of class.
Official Transcript Fee
$ 20.00 per request
Tuition Fee $500 / course
Audit Fee $200 / course)
Accommodations (Room and Board) for part-time students are available for a fee of $50
Two Personal References are required to be submitted using the forms below.
One must be completed by a Pastor, Youth Pastor or Christian Leader, and the other completed by
an Adult Christian friend who is not a relative.
The completed reference forms should be mailed directly to Living Word Bible College at:
Living Word Bible College
Swan River, Manitoba
or emailed to with the subject heading, "Personal Reference Submission". email@example.com Submit Application * Required Fields