Staff Application Form (YWAM Nicoya, Guanacaste)

Consent for treatment
In case of emergency, I/we hereby agree to the performance of such treatment, including anesthesia and surgery, as the attending doctor or physician may deem necessary.
Date *

Day Month Year
Date
Applicant's signature *

Clear
Release of Liability
I hereby release Youth With A Mission, it's agents, employees, and volunteers 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. In accordance with biblical principles, I agree to resolve any and all disputes with Youth With A Mission, YWAM Leader, or staff by means of reconciliation or mediation and waive any right to pursue action by way of litigation.
Date *

Day Month Year
Date
Applicant's signature *

Clear
Statement of Burial and Mediation
BURIAL STATEMENT

We at Youth With A Mission Nicoya, Guanacaste encourage each YWAM student and volunteer to seriously consider some possible consequences of missions work and training. Although death is extremely rare in service with Youth With A Mission internationally, it is nevertheless an experience that awaits each one of us eventually. It is important that we all prepare for such possibilities and have a clear plan of action if such instances arise during our time of study or service within Youth With A Mission.

In extensive travel in less developed countries, diseases are more prevalent, fatal accidents, sickness and mishaps can occur. YWAM Nicoya, Guanacaste does everything possible to protect staff and students while on the field, but death is something that can occur. In these countries, burial is often a real problem.

We endeavor to maintain a Christian view of death, it is not the final step, but just a passage; the person is not in the coffin, just his/her earthly shell. Therefore the priority for limited resources on outreach must be for the living.

In case of death, YWAM Nicoya, Guanacaste cannot commit to cover the expenses of burial or transport home from the country of death (developed or non-developed countries alike). We would strongly encourage burial on the field, as decay can start very quickly. Shipping a body home could cost several thousand dollars and often a special expensive coffin is required by law in some countries as well as having someone accompany the coffin on the return journey. If the family desires to see a body transported back home, the family must incur the entire cost. Any burial costs incurred while on outreach (in the country that the death and burial occurs) are the responsibility of the deceased’s family as well. Note: It is the responsibility of every individual or family (staff or volunteer) to have the Field Burial or Death Related Remains Transport Insurance, not YWAM Nicoya, Guanacaste.
I agree that in case of my death while on outreach in conjunction with Youth With A Mission Nicoya, Guanacaste, that they may carry out the burial in the location of my decease. If my family desires to see my body shipped home, they will agree to cover all expenses incurred. I hereby absolve Youth With A Mission Nicoya, Guanacaste, its staff and associates, from any responsibility for burial costs.
Applicant's name *

First Name Last Name
Applicant's signature *

Clear
Date *

Day Month Year
Date
Acknowledgement of Financial Responsibility
Do you have the prayer and financial support base to enable you to fulfill your intended commitment to YWAM Nicoya? *

Yes No
Do you have the following required support: $300 USD a month ($75 USD a month if you live off the base), the cost of your personal and travel expenses? *

Yes No
If no, how much do you have at the moment?
What is your plan for raising the funds you are still missing?
Do you have any outstanding debt. If yes, please explain: *
Commitment to financial responsibility: *

I understand that payments of the required missionary member fees must be made in US or Costarican currency during the first two weeks of each month. I agree to meet in a timely manner all personal expenses incurred during my involvement with Youth With A Mission Nicoya, Guanacaste. Any unpaid fees and personal expenses will be considered an outstanding debt and are expected to be fully paid in short order.
Date *

Day Month Year
Date
Applicant's signature: *

Clear

Personal History

Please prayerfully and concisely answer the following questions.
Please describe your conversion experience and present spiritual relationship with the Lord. *
What areas of your character are you presently seeking God to further develop and improve? *
How do you see God's call on your life? Do you feel God is leading you into any particular area? *
Are you presently seeing a professional counsellor for any issues? Do you have any present counselling needs? *
Are there any outstanding problems, difficulties, or unresolved conflict in your life? (family, relationships, work, finances, etc.) *
How would you describe the relationships within your family? *
How does your family feel about your plans to join YWAM Nicoya? *
Describe your present relationship to your local church and leaders, and your involvement there. Are they supportive of your involvement in missions? *

Reference forms

There are two reference forms that have to be filled out and submitted before your application is processed. Please provide the name, e-mail address and phone number of the persons filling out these forms.
YWAM/DTS LEADER REFERENCE: *

First Name Last Name
Email *
example@example.com
Phone Number *

Country Code Phone Number
PASTOR REFERENCE: *

First Name Last Name
Email *
example@example.com
Phone Number *

Country Code Phone Number
*

If I am accepted by YWAM Nicoya, Guanacaste, I will abide by the Spirit, rules and schedule of the school and the base.
*

I hereby release University of the Nations, and Youth With A Mission Nicoya, Guanacaste, its staff, agents and volunteers from any liability whatsoever arising out of any injury, damage, or loss which may be sustained by said person(s) during the course of involvement with University of the Nations / Youth With A Mission Nicoya, Guanacaste.
*

I understand that the application will not be processed until all the reference forms have been submitted.
Should be Empty:

	1. No experience	2. Little experience, need supervision	3. Considerable experience, need help with tougher problems	4. Extensive experience, can handle difficulties, can train others	5. Professional training and experience
Electrical work
Car repair and maintenance
Construction
Carpentry
Plumbing
Landscaping/Gardens
Cooking
Event management
Accounting
Graphical Design
Computer programming
Sound equipment
Cleaning
Counseling
Administration
Motivating and training others
Hospitality
Translation
Dance
Visual arts
Music
Speaking/teaching
Work with children
Work with teens
Work with adults
Health care
Discipleship

	Have	Don't have	How many times you have received this immunisation	Date of last immunisation/booster (dd/mm/yyyy)
Diphtheria
Tetanus
Pertussis
Polio
Rubella
Measles
Mumps

Missionary Member Application, YWAM Nicoya, Costa Rica

Contact Details

Passport & Visa Details

Family Information

Educational and Work Information

Language skills

Skills and Abilities

Consent for treatment

Release of Liability

Statement of Burial and Mediation

Acknowledgement of Financial Responsibility

Health Information

Immunizations

Personal History

Reference forms