Staff Application Form

Staff Application Form
Guide to completing this application form:

Thank you for applying to be a volunteer staff member with us here at Pacific Reach!

To serve as volunteer staff you must have first successfully completed a DTS and be at least 18 years old.

Each individual must complete a separate application form.

We ask you to REFRAIN from making travel arrangements until you have both a confirmation of acceptance to staff AND have applied for and received the appropriate visa (if applicable).

Please make sure you read the instructions carefully.

We MUST RECEIVE each of the following items in order for us to process your application.

APPLICATION FORM:
Please answer every question, in all of the sections. If a question does not apply to you, write N/A on the line.

RECENT PHOTO:
You will need to attach a recent photo of yourself at the end of this application form.
Make sure the photo is a clear headshot. Minimum of 72dpi and 600x600 pixels.

2 CHARACTER REFERENCES:
To have the references filled out please fill in the following boxes:
Your Name*

First NameLast Name
Email
example@example.com
Pastor / Spiritual Mentor Name*

First NameLast Name
Pastor / Spiritual Mentor Email*
YWAM Leader Name*

First NameLast Name
YWAM Leader Email*
Can be your DTS, outreach, or most recent YWAM leader

Position you are applying for*
Estimated start date*

DayMonthYear
Length of service anticipated *

Emergency Contact Information
Name of Emergency Contact*

First NameLast Name
Relationship to Emergency Contact*
Address of Emergency Contact*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Country CodeArea CodePhone Number
Email*
example@example.com
Name of Alternative Emergency Contact*

First NameLast Name
Relationship to Emergency Contact*
Phone Number*

Country CodeArea CodePhone Number
Email*
example@example.com

Passport Information
Do you have a current passport?*

YesNoNo, but I am applying for a new one and will send the info once received
Citizenship*
Any other passports or citizenships held
Please list all

Previous Experience
List YWAM school(s) (DTS and any secondary schools), including location, date, and school leader. *
List outreaches, including location and date.*
Previous volunteer staff roles - list most recent positions, bases and dates.

Church Information
Home Church*
Denomination
Phone*
Church Website
Length of time attended*
Your involvement in the church*
Pastor's name*
Does your pastor know about your decision to join Pacific Reach as a volunteer staff member?*

YesNo
Is your pastor supportive of your decision to join Pacific Reach as a volunteer staff member?*

YesNo

Financial Support
Are you in debt?*

YesNo
Would your debt interfere with your long-term commitment?*

YesNo
Please explain your answer*
Do you have monthly pledged financial support?*

YesNo
Total monthly support in NZD$*
If you do not have enough monthly financial support how do you plan to support yourself?*
Please Note - Volunteer Staff boarding cost are $150/week. Mission Builders boarding cost are $189/week. Staff pay boarding costs in monthly instalments in advance of the commencement of that month.

Personal Questions

Please take some time to answer the following questions. Application is NOT COMPLETE until all questions have been answered.
1. Describe how you became a Christian and your present relationship with the Lord.*
2. What areas of your character are you presently seeking God to further develop / improve?*
3. What are your expectations for joining Pacific Reach as a volunteer staff? (i.e. you want to be challenged, grow closer to God, grow in leadership) Please explain.*
4. Do you consider yourself to be 'teachable' - open to correction, guidance, and discipleship?*
5. How do you respond to changes in situations and new environments?*
6. How would you describe yourself? Your personality, nature, habits etc.*
7. What other church involvement or Christian work have you had? (If different from section in Church Information) *
8. Do you feel you have a particular ministry? (worship leading, teaching, medical, administration etc.)*
9. How would you describe your relationships with your immediate family? *
10. Is there a domestic situation that could make it necessary for you to return home? *
11. How does your family feel about your decision to join Pacific Reach as a volunteer staff member? *
12. Are there any significant adverse issues that have traumatically affected you? (physical/sexual assault/abuse, divorce, trauma/accidents etc.)*
13. Are you presently struggling, or have you struggled in the past with any addictions such as alcohol, sexual relationships, pornography, drug abuse (pot, cocaine, heroin etc), eating disorders (anorexia, bulimia, etc.), self harming, suicidal thoughts, or suicidal attempts?*

YesNo
If yes, which issues? Please elaborate, explaining how you have dealt with or are dealing with these issues, and when the last time was you struggled with this.*
14. Have you ever suffered from depression, anxiety attacks, mental disorders (bipolar, schizophrenia, manic depression, etc.)? If yes, are you clinically or self-diagnosed? Please explain.*
15. Are you currently taking any doctor prescribed medications for depression, mental illness or other health issues? If yes, please give details of your condition. *
Please Note: All volunteer staff are required to obtain their own police record from their country of origin and forward this to us. This is necessary for processing this application. If you have any questions, you can email us.
16. Have you ever been involved in a crime? Do you have a police record or history?*

YesNo
If yes, please explain*
17. Are you involved in any current or pending lawsuits/legal proceedings?*

YesNo
If yes, please explain*
18. What has been the most noticeable change in your character since the completion of your DTS?*
19. What are your long-term ministry goals and life's calling?*
20. Why do you want to join Pacific Reach as a volunteer staff member?*

SKILLS LIST

ADMINISTRATION: Accounting General office Organizing/filing Receptionist	SERVING: Cooking Gardening/plant care Hospitality Housekeeping Landscaping
COMMUNICATION: Fundraising Graphic design Promotions Video / DVD making/editing Web design Writer / storyboard	COMPUTERS: Data entry General knowledge Mac proficiency Microsoft Office Networking Other application PC Programming Repair
CONSTRUCTION: Carpenter Concrete Drywall Electrical Flooring General labor Painter Plumber Roofer Tiler Welder/steelwork	MECHANICAL: Auto
MUSICAL / ARTISTIC: Bass Drums Guitar Singing Other instruments Acting Dance Draw Paint Other talents

Please type into the box any areas from the lists above that you are skilled in.*
Are there any other skills you have that are not mentioned above?*

HEALTH INSURANCE PROVIDER
All volunteer staff MUST SHOW proof of medical coverage/insurance which covers your time in NZ and also overseas.

We recommend Talent Trust Consultants - www.talent-trust.com
as a trusted medical insurance provider. TTC also offers group discounts so be sure to mention that you are with Pacific Reach (YWAM).

Please provide your insurance details below, or email them once obtained. We require a copy of your Insurance Policy Certificate.
Do you have health Insurance*

YesNo
Health Insurance Provider*
Company Phone Number*

Area CodePhone Number
Health Insurance Policy #*
Applicant's name*
Applicant's signature*

Medical History

NOTE - Please arrange to bring all necessary long-term medications with you as continuing supplies may not be available.
Do you currently smoke or drink alcohol?*

Yes - smokingYes - alcoholYes to bothNo
If yes to either, please specify what, how much, and how often*
Pacific Reach has a NO SMOKING policy and all volunteer staff are expected to quit before coming.*

I understand
Do you have any physical handicaps, limitations, or health conditions which may require special attention?*

YesNo
If yes, please detail*
At Pacific Reach anyone requiring "Gluten or Dairy Free Meals" will be asked to make a $300 contribution per school to help cover the extra costs of these meals.
Please list any food allergies or special dietary needs you may have. *
If none, enter N/A in the box
Please list any other allergies you may have. *
Includes: Penicillin, Serum, Sulfonamides or other medicines, and any other types of allergies.
Do you have a current first aid certificate?*

YesNo
Date of course

MonthDayYear

Medical History Contd.
Have you had any of the following communicable diseases? (Tick all that apply)*

Chicken PoxGerman Measles (Rubella)English Measles (Rubeola)MumpsPertussisScarlet FeverTuberculosisNone of the above
Any other communicable diseases we haven't yet mentioned?*

Consent for Medical Treatment

In case of an emergency, I, hereby agree to the performance of such treatment, anaesthetics, and operations as is deemed necessary by the attending physician.
Applicants signature (Typing your name confirms you agree)*

First NameLast Name
Date*

MonthDayYear
Date

Liability Release Form

I / we hereby release Pacific Reach, its agents, employees, and volunteers from any liability whatsoever arising out of an injury, damage, or loss which may be sustained by said person during the course of involvement with Pacific Reach.
Applicant's Signature (Typing your name confirms you agree)*

First NameLast Name
Date*

MonthDayYear
Date

Statement of Burial

Pacific Reach does everything possible to protect volunteer staff and students on the field. Although death is extremely rare, it nevertheless needs to be considered. Pacific Reach strongly encourages burial on the field, as decay can start very quickly and as transport of the body from the overseas location can be very costly.
In order to be shipped, some laws require a special coffin and the coffin must be accompanied by someone on the return journey. In case of death, Pacific Reach cannot commit to cover the costs of shipping the body to another country for purposes of burial or to ultimately cover the burial costs in the country of death. If the family desires to see the body transported back home, the family must incur the cost.
Consent for Burial

I agree that in the case of my death while in Pacific Reach, Pacific Reach may carry out the burial in the location of the deceased. If my family desires to have my body shipped home, my family is prepared to pay all costs. I hereby absolve Pacific Reach and all its volunteer staff and associates of the burial and transport costs.
Applicant Signature (Typing your name confirms you agree)*

First NameLast Name
Date*

MonthDayYear
Date

Signature of Financial Understanding
The boarding cost of volunteer staff at Pacific Reach is currently $150/week.

The boarding cost for mission builders at Pacific Reach is currently $189/week.

Both costs include food, accommodation, and utilities. However, it does not include personal expenses, insurance, and domestic travel.

Invoices are generated monthly and expected to be paid in full by the end of the month.

Volunteer staff members and mission builders are responsible for their own travel costs to and from our location. This includes any outreach airfares and outreach fees if applicable.
I confirm I understand my financial obligations to Pacific Reach, and that payment of required fees must be made monthly and I agree to do so. I, therefore, commit myself to pay all personal expenses incurred during my time with Pacific Reach.
Applicants signature (Typing your name confirms you agree)*

First NameLast Name
Date*

MonthDayYear
Date

Signature of Agreement
I consent to submitting my personal information to Pacific Reach for the purposes of processing this application and the facilitation of my volunteer service should I be accepted
YesNo
I certify that all information in the application is complete and accurate. If accepted by Pacific Reach I will abide by the spirit, rules, and schedule of the ministry.

In accordance with biblical principles, I agree to seek to first resolve any and all disputes with Pacific Reach, its leadership, and/or volunteer staff members by means of reconciliation or mediation.
Applicants signature (Typing your name confirms you agree)*

First NameLast Name
Date*

MonthDayYear
Date

Submit Application

You made it!
It's now time to submit your final and completed application. Simply click on the "submit application" button below and your application will be sent directly to Pacific Reach for processing.

We look forward to communicating with you more in the very near future.

God Bless!

Pacific Reach Team

personnel@marinereach.com
Should be Empty:

Staff Application Form

Personal Information

Emergency Contact Information

Passport Information

Previous Experience

ENGLISH PROFICIENCY

Church Information

Financial Support

Personal Questions

SKILLS LIST

HEALTH INSURANCE PROVIDER

Medical History

Medical History Contd.

Medical History Contd.

Immunizations

Medical History Contd.

Consent for Medical Treatment

Liability Release Form

Statement of Burial

Consent for Burial

Signature of Financial Understanding

Signature of Agreement

Submit Application