Youth Reach Youth Application Form

A Non-governmental Organization/Member of the Council for Voluntary Social Services/United Way Registered with the Ministry of Education An Outreach Ministry of Swallowfield Chapel

Read and follow the instructions carefully prior to submitting your application.

Being called to minister for God is a high calling and should be undertaken with prayer. We need to recognize that the chief concern of Christians is to glorify and honour Christ through a holy life and to have a deep concern for the lost (1 Corinthians 2:2).

Full Name*

First NameLast Name

Gender:

MaleFemale

Birthdate:*

MonthDayYear

Mobile No. :*

Area CodePhone Number

E-mail :*

Where the confirmation will be send to

Home Address :*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Name of Church

Denomination

Church Address :

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Church Phone Number :

Area CodePhone Number

Number of years you have been a Christian

Check the box that indicates education level you have completed*

Please list below : All School Attended, Year/s attended and Graduation year.*

0/300

Please list subject/s achieved and grade, if any (CXC, CAPE, SSC, etc)

0/300

Who do you live with? Please write the names & contact numbers of Parents/Guardians.*

Cell Number of Guardian*

Area CodePhone Number

Home Number of Guardian

Area CodePhone Number

Who has been supporting you financially?*

How does this person/family feel about your plan to join YRY?*

What is your biggest concern about joining this programme?*

In what youth leadership position or activities have you participated in or do you currently participate? Please indicate any leadership positions you have held or currently hold.*

Describe volunteer activities, interests and hobbies*

Have you ever been in trouble with the law?*

YesNo

If Yes, Please explain.

Have you ever been suspended/expelled from school, fired from your job or put under church discipline? If yes, why?

Do you have any children or is one on the way?*

YesNo

How would you describe your health/medical?

How would you describe:

A. Your ability to relate to your peers? (Do you have friends?)

B. Your ability to relate to authority?

Which area in the field of youth development would you like to see changed five years from now and how do you propose to help to achieve this change?*

What do you hope to gain by being a part of the Youth Reaching Youth Mission?*

Will you be able to commit to the programme for one year? (Must be available between the hours of 8:00 a.m. – 4:00 p.m. Mondays – Fridays and be willing to minister on weekends).*

YesNo

If No, Please state reason

Please state your vocational goal/s.

Please state how you heard about the programme:

If other, Please state how.

Referral Code (Please enter current Youth Leader full name) :

By signing (typing your legal name) in the space below, you are certifying that all information is correct and that you are the person completing this application. When you press the submit button, you will receive an email confirmation that your application was received.

TRN*

NIS*

Date

E-Signature:*

Please print, sign and take with you on day of your interview.

Pastor's Reference Form

Youth Reaching Youth Application Form

I. Personal Data:

VIII. Applicant's E-Signature