Vox Bivium Application
2018-2019


Name *
Name
Address *
Address
Phone *
Phone
Birthday *
Birthday
* Please include address if different than above.
EDUCATION - INTERESTS
List any other schools such as trade schools, colleges , or universities ?
Of the following, what are some unique abilities or experiences that you would bring with you to Vox Bivium next year: *
Check all that apply
If given the opportunity, I would like to learn more about the following during my time at Vox Bivium: *
Please check all that apply
RELATIONSHIPS - PERSONAL DEVELOPMENT - BELIEFS
Be sure to describe how it affected you both personally and spiritually.
If "no", please share what you feel is the hardest part of setting goals.
No pressure here, just share one that you read and found interesting... it can simply be your "favorite" book if you would like.
Please choose which best describes you
Share what Christianity and your relationship with Christ looks like for you...
This can include both what you believe and what you do.
This can include what you don't understand, "wrestle" with, or find most challenging to do.
MEDICAL
Do you have any allergies? *
Please check all that apply:
Do you suffer from any of the following: *
Please check all that apply; answers are kept confidential:
Are you currently or have you ever: *
Please check all that apply; answers are kept confidential:
Know that this does not discount your ability to be a part of Vox Bivium; all answers are kept confidential:
Other Medical Considerations: *
Please check all that apply:
REFERENCES
Church or Community Related Reference: *
Church or Community Related Reference:
Pastor, Sunday School Teacher, Bible Study Leader, Local Volunteer Coordinator, Other Non Family Member
Phone *
Phone
Work or School Related Reference *
Work or School Related Reference
Supervisor, Manager, Teacher or Coach
Phone *
Phone
Other Adult Reference *
Other Adult Reference
This is someone older than you that is not a family member or peer.
Phone *
Phone
Todays Date *
Todays Date