HENRY MORTON STANLEY SCHOOL OF CHRISTIAN JOURNALISM
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Henry Morton Stanley
School of Christian
Journalism
Application Form
1. Personal Data
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Indicates required field
First Name
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Middle Name
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Last Name
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Street Address
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Home Phone
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Postal Address
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Work Phone/Cell Phone
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City
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State/ Province
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Code
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Country
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E-mail Address
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Fax Number
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Date of Birth
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Nationality
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Place of Birth
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Passport Number:
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Expiration Date:
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Identity Number:
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2. Marital Status
Choose One
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Single
Married
Spouse’s Name
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Nationality of Spouse
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Number of Years Married
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3. Employment Information
Occupation
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Date of Employment
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Employer
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Employer’s Phone Number
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Employer’s Address
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4. Church Information
Name of your Church
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Denomination
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Street Address
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Pastor’s Name
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Pastor’s Phone No.
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City
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Province/State
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Code
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Are you a Member of your Church?
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Yes
No
If Yes, Date of Membership
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Please Describe your Participation in your Local Church
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5. Education
Please list schools attended. Start with the most current.
1# Name of School
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1# City/State
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1# Degree/Certificate
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1# Year
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2# Name of School
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2# City/State
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2# Degree/Certificate
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2# Year
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3# Name of School
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3# City/State
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3# Degree/Certificate
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3# Year
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4# Name of School
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4# City/State
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4# Degree/Certificate
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4# Year
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5# Name of School
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5# City/State
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5# Degree/Certificate
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5# Year
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6. Spiritual Gifts, Talents, Abilities, Hobbies and Interests
Please List your Spiritual Gifts
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Other Skills Talents / Abilities
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Hobbies/Interests
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What Books Have Most Influenced your life?
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What Films Have Most Influenced your Life?
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7. Do you Speak any more Languages other than English?
1# Language
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1# Level
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None
Level 1
Level 2
Level 3
Level 4
Level 5
2# Language
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2# Level
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None
Level 1
Level 2
Level 3
Level 4
Level 5
3# Language
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3# Level
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None
Level 1
Level 2
Level 3
Level 4
Level 5
4# Language
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4# Level
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None
Level 1
Level 2
Level 3
Level 4
Level 5
5# Language
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5# Level
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None
Level 1
Level 2
Level 3
Level 4
Level 5
7. Experience and Intentions
Do you have any Experience in Writing or Journalism? Please Describe
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What Involvement do you have in Social Media?
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Why do you want to Study through HMSSCJ?
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What do you Believe is the Ultimate Calling God has Placed upon your Life?
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8. Interests and Influence
What Fields most Interest you?
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1) Animal Rights
2) Conservation
3) Pro-Life
4) Pro-Family
5) God and Government
6) Politics
7) Art
8) Music
9) Human Rights
10) Education
11) History
12) Sport
13) Science
14) Business
15) Environment
16) World News
What types of Media most Interest you?
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1) Letters to editor
2) Magazines
3) Newspapers
4) Radio
5) Social Media
6) Investigation
7) Photography
8) Television
9. Books
What Book/s are you Reading at this Time?
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What Books have you Read in the Last Year?
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What are the most Influential Books that you have ever Read?
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How much Time do you spend Reading in an Average Week?
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When do you do most of your Reading?
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How many Books have you come to own?
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Do you Regularly visit and Borrow Books from a Library?
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How many Books Might you Borrow from Libraries in an Average Year?
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What sort of Books do you Generally Read?
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1) Biographies
2) Devotionals
3) Doctrine
4) Inspirational
5) Motivational
6) Fiction
7) Non-fiction
8) Historical Novels
9) History
10) Educational
11) Wildlife
12) Animals
13) Theology
Who are your Favorite Authors?
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Which Magazines do you Read?
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Do you have any Favourite websites?
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Which Newspapers/Newsletters do you regularly read?
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When you Read do you Generally Make Notes a Book?
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Are there any Books that you Have Thoroughly Studied?
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Please indicate how much of the following magazines / newsletters you read
a) Christian Action
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Don't Read
Sometimes Read
Generally Read
Always Read
b) Frontline Fellowship News
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Don't Read
Sometimes Read
Generally Read
Always Read
c) Gospel Defence League
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Don't Read
Sometimes Read
Generally Read
Always Read
d) Movieguide
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Don't Read
Sometimes Read
Generally Read
Always Read
e) Time
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Don't Read
Sometimes Read
Generally Read
Always Read
f) World
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Don't Read
Sometimes Read
Generally Read
Always Read
Other (Specify)
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Are there any audio books that you have listened to?
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How many Books do you Read in an Average Year?
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What Books do you plan to Read this Year?
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How Much Time do you Spend Reading the Bible in a Week?
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Which are your Favourite Books of the Bible?
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Have you read the whole Bible?
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Yes
No
Have you read the whole New Testament?
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Yes
No
Which Books would you rate as the most Important Books for every Christian to Read?
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HENRY MORTON STANLEY
SCHOOL OF CHRISTIAN
JOURNALISM
PO Box 74, Newlands, 7725, Cape Town, South Africa
Tel: +27 (21) 689-4480/1
Fax: +27 (21) 685-5884
E-mail:
hmsscj@frontline.org.za
Web:
www.hmsschoolofchristianjournalism.org
"Therefore, having put away falsehood, let each one of you speak the truth with his neighbour..."
-
Ephesians 4:25
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