Staff App page2 – ywam

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STAFF APP FORM PG2

1General Info

2Passport Details

3Personal Details

4Additional Info

5Health Declaration

6Agreement

Staff position interested in*
Please specify
1. GENERAL INFORMATIONS
Applicable for all applicants
NAME*
*Name as in Travel Document
First Last
Gender*
Other Language/s Spoken
Marital Status*
Date of Marriage*

Day
Month
Year
Name of Spouse/ Fiance*
* Full Name as in Passport
State if spouse accompanying*
- YES
- NO
If NO, please state why
If NO, please state why*
Accommodation Required*
For family with children please indicate below
Number of Adults + Children*
*please indicate number of family member require accommodation for family

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2. PASSPORT DETAILS
Applicable for all applicants
Citizenship*
Place of Birth*
Passport Number*
Passport Issue Date*
DD slash MM slash YYYY
Passport Expiry Date*
DD slash MM slash YYYY
Country of Issue*

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3. PERSONAL DETAILS
Name of Spouse/Fiance*
Name Date of Birth
Father's Name*
Name Date of Birth
Mother's Name*
Name Date of Birth
Sibling's Name*
* add more rows by hitting +
Name Gender Date of Birth
Child/ren's Name*
* add more rows by hitting +
Name Gender Date of Birth
3B. EDUCATIONAL BACKGROUND*
Please order your educational experience chronologically, the most recent first.
Name of School Country Degree Obtained Date Attended (From/To)
3C. PAST AND PRESENT EMPLOYMENT*
List all employment experience chronologically, the most recent first.
Name of Company Country Designation Duration of Work (From/To)
4. CHURCH INFORMATION
Name of Church*
Denomination
Pastor's Name*
First Last
ADDRESS OF CHURCH*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Email*
Member Since*
Does your church support the idea of you attending a YWAM School?*
Comments*
5. CRIMINAL RECORDS
Have you ever been cautioned, charged or convicted of a criminal offence in any country, or do you have any cases pending?*
- YES
- NO
Have you ever been the subject of a police investigation in any country that did not lead to a conviction?*
- YES
- NO
If YES, Please explain*

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6. CHRISTIAN LIFE AND EXPERIENCE
Please take time to prayerfully answer the following questions
1. What areas of ministry do you think you are most effective and/or comfortable in and least effective and/or comfortable in? Feel free to list more than one.*
2. What spiritual gifts do you think God has given you? Reflect on the ways God has used you in the past.*
3. Do you have a long-term (2-5 years) call to missions in this region (Asia) and/or a call to YWAM Singapore’s objectives and goals? Please elaborate.*
4. List any church work and/or YWAM experience. If you are an ordained or licensed clergyman, please elaborate.*
5. List any previous involvement with other mission agencies/organizations. This includes short term involvement, staff or leadership appointments. What were your reasons for leaving?*
6. We are committed to on-going discipleship in YWAM. Are there any critical, urgent personal issues you are currently working on that we can be of assistance to you or should be aware of?*
7. Have you communicated to your church/pastor regarding your plan to serve with YWAM Singapore? Describe their response and your relationship with your home church.*
please indicate if you had leadership experience
8. Are you in debt? If yes, please elaborate.*
9. Is there anything else you would like to share with us?*
* anything else you think / feel that YWAM Singapore should know?

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7. HEALTH DECLARATION
Heath Status*
Other than minor aliment, have you had any accident / illness that required medical or surgical attention?*
If yes, please give details:*
Are you currently on any form of medication / doctor’s review?*
If yes, please give details:*
Are you pregnant*
Do you have any disabilities that could limit your participation in the school curriculum?*
Do you suffer from / have you been treated for any of the following?*
- Hypertension
- Fainting spell
- Diabetics
- Kidney / genital urinary system disease
- chest pain
- heart disease
- epilepsy
- anemia
- stroke
- hepatitis
- migraine
- drug allergy
- heavy snoring during sleep
- disease of muscles / bones
- disease of brain / nervous system
- disease of blood / metabolism
- respiratory disorder / asthma
- Food allergy
- others
- NONE
If yes to any of the above, please give details:*
Is there anything more about your health / physical condition that you feel we should know:*
Do you have valid “hospitalization and surgical INSURANCE” (or similar) that covers you while overseas?*
- YES
- NO
If yes, please indicate:*
Name of Company Policy Number Policy Contact No Expiry Date
8. EMERGENCY CONTACT
In case of emergency, YWAM Singapore may contact:
Name*
First Last
Relationship to Applicant*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Please provide a number that can be contacted even during odd hours
Email*
Comments, if any

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9. RELEASE OF LIABILITY
I do hereby release Youth With A Mission (Pte) Ltd., its agent, employees and volunteer assistants from any liability whatsoever arising out of any injury, damage or loss which may be sustained by said person during the course of involvement with Youth With A Mission.*
- Agree
- Disagree
10. CONSENT FOR TREATMENT
In the event of an emergency in which I am rendered unconscious and my nearest responsible relative or guardian cannot be contacted,
I (applicant) hereby agree to such treatment, anesthetics and operations as in the opinion of the attending physician / surgeon who is deemed necessary.*
- Agree
- Disagree
11. CONSENT FOR BURIAL
I (applicant) hereby grant consent for the burial / cremation of my body in accordance with the law of the nation, in the event of my death while in the commitment with Youth With A Mission (Singapore).*
In case of death, the law of the country may require that the deceased be buried or cremated. While every attempt will be made to fulfill the family’s wish of disposition of the deceased, this may not be possible.
- Agree
- Disagree
12. DISCLOSURE OF INFORMATION AGREEMENT
I (applicant) hereby understand and agree to the disclosure of the above information for YWAM’s publications and publicity purposes.*
The form indicates the agreement for disclosure of applicant’s name, photographs, art/written work, voice, verbal statements and / or portraits for publicity materials, publication and / or website of any form regardless of time frame within organizational and schools’ context with acknowledgement of (A) No monetary consideration shall be paid. (B) Above agreement is binding upon heirs and / or future legal representative(s).
- Agree
- Disagree
13. DECLARATION
I declare all information declared in this application form and its attachments to be true and correct. I have not withheld any relevant information. If I am accepted as a staff of YWAM, I agree to embrace the values of the mission, comply with the leadership structures in place in YWAM Singapore, and abide by the general ministry policies, to respect the property of YWAM and its people in a spirit of true submission. I also agree to the use of (including the disclosure of) information supplied on my application form by the staff of YWAM for any purpose related to my staff appointment, development or well being.*
- YES
- NO
I declare that I am above 18 years old at the commencement date of applied YWAM staff position.*
Consent of a parent / legal guardian on applicant’s behalf is required for agreement to above clause.
- YES
- NO
Name Of Applicant*
First Last
Date of Submission*
DD slash MM slash YYYY
Signature of Applicant
** To be signed on arrival

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