Include Recent Photograph (Please staple to application or email to: joeldmattila@gmail.

com)

INTERNATIONAL SCHOOL OF REVIVAL

STUDENT APPLICATION
Date of Application: D_____M______Y______

Fee (US Currency): $___________

Identity:
Last name:________________________ First name:__________________________ Middle:________
Nickname:___________________ Sex: [ ]Male [ ]Female Age:____ Birthdate: D____M_____Y_____
Birthplace:_________________________
Mailing address:
Street/Box:_____________________________________________________________________________
__________________________ City/Town:___________________________________
State:_________________ Zip:_____________ Country:______________________
Permanent address:
Street/Box:_____________________________________________________________________________
__________________________ City/Town:___________________________________
State:________________ Zip:______________ Country:______________________
Phone:___________________________
Email:__________________________________________________________________________
Marital status:
[ ]Single
[ ]Engaged (Date: D_____M______Y_____) [ ]Married (Date: D_____M______Y_____)
[ ]Separated (Date: D_____M______Y_____) [ ]Divorced (Date: D_____M______Y_____)
[ ]Remarried (Date: D_____M______Y_____) [ ]Widowed (Date: D_____M______Y_____)
Spouse last name:_______________________________________
First name:____________________________________ Middle:_________ Sex: [ ]Male [ ]Female
Birth date: D_____M______Y_____
Birthplace:_______________________________________________________
Will your spouse be accompanying you? [ ]Yes [ ]No

Children:
Last name:________________________________________
First name:______________________________________ Middle:_________ Sex: [ ]Male [ ]Female
Birthdate: D_____M______Y_____ School grade:________________________
Last name:________________________________________ First
name:______________________________________ Middle:_________ Sex: [ ]Male [ ]Female
Birthdate: D_____M______Y_____ School grade:________________________
Last name:________________________________________ First
name:______________________________________ Middle:_________ Sex: [ ]Male [ ]Female
Birthdate: D_____M______Y_____ School grade:________________________

Page 1

INTERNATIONAL SCHOOL OF REVIVAL

STUDENT APPLICATION
Criminal record: (If answer to either question is yes, please explain details on separate sheet of paper.)
Have you ever been convicted of a felony? [ ]Yes [ ]No If so, when and
where?_____________________________________________________________________________
Have you ever been convicted of a sexual crime? [ ]Yes [ ]No If so, when and
where?_____________________________________________________________________________
Emergency information:
In case of emergency contact:________________________________________________________
Relationship:_____________________
Street/Box:________________________________________________________________________
Phone:_________________________ City/Town:___________________________________
State:_________________ Zip:_____________ Country:______________________
Email(s):_______________________________________________________________________________
______________________________________________________________________________________
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.
Applicants
signature:________________________________________________________________________
Date: D_____M______Y_____ Parent/Guardians signature (required for
minors):_________________________________________________ Date: D_____M______Y_____
Church information:
Home Church:___________________________________ Pastor:____________________________
Denomination:____________________
Street/Box:________________________________________________________________________
Phone:_________________________ City/Town:___________________________________
State:_________________ Zip:_____________ Country:______________________
Work experience: (Please list all work experience for the last 10 years, starting with most recent.)
Position:____________________________ Company:____________________________________
Dates: M______Y_____ to M______Y_____ Supervisor:________________________________________
Skills used:_____________________________________________________
Position:____________________________ Company:____________________________________
Dates: M______Y_____ to M______Y_____ Supervisor:________________________________________
Skills used:_____________________________________________________
Position:____________________________ Company:____________________________________
Dates: M______Y_____ to M______Y_____ Supervisor:________________________________________
Skills used:_____________________________________________________
Position:____________________________ Company:____________________________________
Dates: M______Y_____ to M______Y_____ Supervisor:________________________________________
Skills used:_____________________________________________________
Position:____________________________ Company:____________________________________
Dates: M______Y_____ to M______Y_____ Supervisor:________________________________________
Skills used:_____________________________________________________
Skills and talents:
Occupational
skills:___________________________________________________________________________
Years experience:______
Musical or other
talents:________________________________________________________________________
Years experience:______
Page 2

INTERNATIONAL SCHOOL OF REVIVAL

STUDENT APPLICATION
Languages: (Please identify and rate your English language proficiency below.) [ ]1-Elementary speaking
[ ]2-Limited word proficiency [ ]3-Minimum professional proficiency [ ]4-Full professional proficiency
[ ]5-Native speaking proficiency
[ ]6-Mother tongue
Other languages and
proficiency:_____________________________________________________________________________
______________________________________________________________________________________
Educational experience:
Grades completed: [ ]Grade school [ ]Secondary/High school [ ] Equivalent secondary/high school
[ ]College/University [ ]Post graduate Institution:____________________________ Dates: M_____Y____ to
M_____Y____ Degree/Major ____________________ Date: M_____Y____
Address:_______________________________________________________________________________
___________________________
Institution:____________________________ Dates: M_____Y____ to M_____Y____
Degree/Major ____________________ Date: M_____Y____
Address:_______________________________________________________________________________
___________________________
Institution:____________________________ Dates: M_____Y____ to M_____Y____
Degree/Major ____________________ Date: M_____Y____
Address:_______________________________________________________________________________
___________________________
Institution:____________________________ Dates: M_____Y____ to M_____Y____
Degree/Major ____________________ Date: M_____Y____
Address:_______________________________________________________________________________
___________________________
Institution:____________________________ Dates: M_____Y____ to M_____Y____
Degree/Major ____________________ Date: M_____Y____
Address:_______________________________________________________________________________
___________________________
Institution:____________________________ Dates: M_____Y____ to M_____Y____
Degree/Major ____________________ Date: M_____Y____
Address:_______________________________________________________________________________
___________________________
YWAM background:
Have you previously attended a YWAM school? [ ]Yes [ ]No School:_______________________________
Lecture phase dates: M______Y_____ to M______Y_____ Location:__________________________
Field assignment phase dates: M______Y_____ to M______Y_____
Location:__________________________
School:_______________________________ Lecture phase dates: M______Y_____ to M______Y_____
Location:__________________________ Field assignment phase dates: M______Y_____ to
M______Y_____ Location:__________________________
School:_______________________________ Lecture phase dates: M______Y_____ to M______Y_____
Location:__________________________ Field assignment phase dates: M______Y_____ to
M______Y_____ Location:__________________________
School:_______________________________ Lecture phase dates: M______Y_____ to M______Y_____
Location:__________________________ Field assignment phase dates: M______Y_____ to
M______Y_____ Location:__________________________
School:_______________________________ Lecture phase dates: M______Y_____ to M______Y_____
Location:__________________________ Field assignment phase dates: M______Y_____ to
M______Y_____ Location:__________________________

Page 3

INTERNATIONAL SCHOOL OF REVIVAL

STUDENT APPLICATION
Financial information:
Do you have your complete school fees? [ ]Yes [ ]No What amount do you have? $___________
Amount still needed? $____________ From what source will still-needed funds come?
__________________________________________________________________________
Do you have any significant outstanding debts? [ ]Yes [ ]No If yes,
explain:________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
Acknowledgment of financial responsibility:
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 the INTERNATIONAL SCHOOL OF REVIVAL. If I am
accepted by the INTERNATIONAL SCHOOL OF REVIVAL, I will abide by the spirit, rules and
schedule of the school.
Applicants signature:_____________________________________________________________________
Date: D______M______Y______ Signature of parent or guardian: (Required if applicant is under 18 years of
age.) Signature:_____________________________________________ Date:
D______M______Y______Relationship:____________________
Expectations:

How did you first hear of the INTERNATIONAL SCHOOL OF REVIVAL?

______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
What reason most influenced your decision to apply?
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
What expectations do you have for this course?
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Certification: I certify that all the information in this application is complete and accurate. Applicants
signature:_____________________________________________________________________
Date: D______M______Y______
Signature of parent or guardian: (Required if applicant is under 18 years of age.)
Signature:________________________________________________ Date:
D______M______Y______Relationship:__________________
INTERNATIONAL SCHOOL OF REVIVAL admits students of any race, color, national and ethnic origin to all the
rights, privileges, programs and activities generally accorded or made available to students at the school. It
does not discriminate on the basis of race, color, national and ethnic origin in administration of its educational
policies, admissions policies and school- administered programs.
Please mail all forms to:
Joel Mattila P.O. Box 820024, Vancouver, WA 98682
Phone: 360-903-9940 Email: joeldmattila@gmail.com

Page 4

PERSONAL HISTORY FORM

Please write 2 or 3 paragraphs on each topic. Use additional pages if necessary.

Personal History - Briefly describe the following:

a. Your conversion experience and present spiritual relationship with the Lord
Jesus.
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
b. The areas of your character you are presently seeking to further develop and
improve.
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
c. Your long-term goals.
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________

________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
d. Your relationship with your local church, including areas of ministry, service
and leadership experience.
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
____________________________
e. Your business, professional, mission-related or other significant experiences.
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________

f. Your relationship with your family.

________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
g. How does your family feel about your plans to enroll at The INTERNATIONAL
SCHOOL OF REVIVAL?
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________

Please mail all forms to:

JOEL MATTILA
P.O. Box 820024, Vancouver, WA 98682
The INTERNATIONAL SCHOOL OF REVIVAL admits students of any race, color,
national and ethnic origin to all the rights, privileges, programs and activities generally accorded or made
available to students at the school. It does not discriminate on the basis of race, color, national and ethnic origin
in administration of its educational policies, admissions policies and school- administered programs.
Phone: 360-903-9940 Email: joeldmattila@gmail.com

INTERNATIONAL SCHOOL OF REVIVAL Waiver, Release and Indemnity

WAIVER, RELEASE AND INDEMNITY __________________________, who is

herein referred to as the "Releasor", hereby releases, waives and forever

discharges the INTERNATIONAL SCHOOL OF REVIVAL , its family,
directors, related ministries, employees, if any, successors, insurers and
volunteers, who are herein collectively referred to as the "School from any and
all liability, claims, causes of action, loss and damage that may result from any
injury to the Releasor's person or property, even injury resulting in death of the
Releasor, arising out of the Releasor being a Student, a Mission Builder, and/or a
Full Time or Associate Staff member at or of the School, including without
limitation of the generality of the foregoing those arising out of or in any way
related to the Releasor participating in any School conducted or sponsored
program or activity whether on the School campus, off campus within or outside
of the State of Washington such as an outreach program which are usually
conducted overseas.
Releasor hereby acknowledges that if Releasor participates in an outreach
program conducted or sponsored by the School or travels internationally on
School business that he or she is fully aware of the fact that his or her personal
health, freedom, safety and/or life may be at risk of loss or damage from
contraction of disease, accidents, terrorism, persecution, war, political unrest and
any other number of circumstances that might while traveling internationally or
while participating in an outreach program and that the Releasor will give such
risks the Releasor's full consideration, prayer and thought in deciding whether or
not to participate in any such activity and has given such risks the Releasor's full
consideration, prayer and thought in deciding whether or not to sign this
instrument and that Releasor has signed this instrument with full knowledge of
those risks, voluntarily, and not under any duress or undue influence of
whatsoever kind or nature.
Releasor hereby knowingly and voluntarily assumes full responsibility for risk of
loss of health, bodily injury, death or damage to Releasor's property arising out of
the aforedescribed risks, programs and activities. Releasor hereby agrees to
indemnify and hold the School harmless from any and all claims, liability, loss,
damage, cost and/or expense, including attorneys fees and costs incurred by the
School in defending against any such claims and in enforcing this agreement,
that may be asserted against the School or that the School may suffer or incur
as the result of Releasor being a Student at the School and/or a Full Time
or Associate Staff member at the School as the case may be.
Releasor expressly agrees that this release, waiver, and indemnity agreement is
intended to be as broad and inclusive as permitted by the laws of the State of
Washington and any other jurisdiction in which any cause of action or claim may
arise or be asserted and is being given as an inducement to the School to allow
Releasor to be a Student at the School or be a Mission Builder, and/or a Full
Time or Associate Staff member at the School, as the case may be, and that if
any portion of this agreement is invalid, it is agreed that the balance shall notwithstanding continue in full legal force and effect. This release, waiver and indemnity
agreement shall be binding on Releasor and Releasor's heirs, personal
representatives, successors and assigns and shall inure to the benefit of the

School and its trustees, directors, officers, agents, employees (if any), insurers
and volunteers.
RELEASOR ACKNOWLEDGES RELEASOR HAS CAREFULLY READ THIS
AGREEMENT, FULLY UNDERSTANDS ITS LEGAL EFFECT AND HAS
SIGNED IT OF RELEASOR'S OWN FREE WILL.
In witness whereof, Releasor has executed this instrument on this day:
___________________, 20___.
Releasor's Signature: ________________________
Print Name:________________________________
Witness Signature: __________________________
Print Name:________________________________