Team Plant

Yes

Role

Trainee

Location

YWAM Immerse Cornwall courses applying for

YWAM Bristol courses applying for

YWAM Mosaic courses applying for

YWAM Newcastle Upon Tyne applying for

Have you completed a YWAM Harpenden online application form in the past twelve months?

NoYes

Title

First Name

Last Name

Personal Information

Preferred name

Gender

Date of Birth

Nationality

Email

Phone number

Mobile Phone

Whatsapp number

Skype Username

Facebook Profile

Paste your Facebook profile URL.

Current Address

Street

City

County/State/Province

Country

Postal Code/Zip Code

Permanent Address (If different from above)

Street

City

County/State/Province

Country

Postal Code/Zip Code

Please keep me in touch with news from this location

We need your consent to receive your application information and to contact you during the application process. By selecting the option to ‘Save my progress and resume later” at any time during the application process or by pressing the 'Submit' button when you have completed the form, you are providing that consent. You have the right to withdraw your consent at any time. To withdraw your consent, please email us at teamplants@ywamharpenden.org. For more information about what we do with your personal data and how we protect it, see our privacy notice.

Marital Status

Spouse/Fiancé's Name:

Are you coming with your Spouse/Fiance?

YesNo

If not, please comment

Is your Spouse/Fiancé also applying for the school?

YesNo

Will any children be accompanying you?

YesNo

Children Details:

First Name, Last Name, Gender, Date of Birth (dd/mm/yyyy), Passport Number, Nationality.

Passport Information

Passport Number

Passport Full Name

Town and Country of Birth

Passport Issue Date

Passport Expiry Date

Passport Place of Issue

Passport Issuing Authority

Have you ever been refused a visa to any other country?

YesNo

Can you please explain?

Emergency Contact Information

Emergency Contact Name

Relationship To Applicant

Emergency Contact Phone - Home

including international dialing code

Emergency Contact Phone - Mobile

including international dialing code

Emergency Contact Phone - Work

including international dialing code

Emergency Contact Email

Emergency Contact Email 2

Emergency Contact Address

Church Information

Church Affiliation

Church Leader's Name

Church Leader's Title

Church Leader's email

Church Leader's Home Phone number

Church leader's Work Phone Number

Church Current Address

Does your church support the idea of you attending a Youth With A Mission (YWAM) School?

YesNoDon't know

Comments

Education and Skills

Secondary School (Education between 16 and 18 years)

Name of Establishment 1

Dates Attended Start

approximate date

Dates Attended End

approximate date

Exam Success/Qualifications Received

University/College/Higher or Further Education (post 18 years)

Name of Establishment 2

Dates Attended Start

approximate

Dates Attended End

approximate date

Exam Success/Qualifications Received

Name of Establishment 3

Dates Attended Start

approximate date

Dates Attended End

approximate date

Exam Success/Qualifications Received

List any other training or qualifications you have received.

What is your most recent occupation?

Position

Employment Start Date

approximate date

Employment End Date

approximate date

Briefly describe what your work entails

Briefly describe other past work experience

Languages

All courses conducted at this location are in English. You will require a sufficient standard of oral and written English proficiency in order to benefit from the training you undertake.

English Proficiency

Language 2

Language 2 Proficiency

Language 3

Language 3 Proficiency

Gifts, Hobbies and Talents

Please indicate your gifts including any drama, musical/artistic talents trade or cooking skills

you have, as well as your hobbies.

Gifts

Hobbies and Talents

Please describe any achievements you feel are highlights over your lifetime so far.

Christian Life and Experience

Describe your conversion experience or explain how God became real and personal to you

What experience do you have of sharing your faith?

What church involvement have you had?

Have you had any leadership experience?

Briefly describe any experiences you have had in other cultures.

How would you describe your Christian life and your relationship with God at the present time?

Personal Questions

Do you feel God has called you into some kind of full time Christian service? Please explain.

How might you see using your skills/gifts/training in a missions context?

How did you hear about YWAM?

What is your reason for applying for this particular school?

What are your hopes and expectations for yourself during this school?

How did you hear about this school?

How do you think you would cope with challenging situations like: different food and culture, dormitory housing or small quarters for families?

Are there any current personal issues which you would like to share with us?

Finances

This section explains the financial costs of attending this school. Please note that all fees are payable in British Pounds ONLY.

Lecture and Outreach:

Our costs covers amongst other things, all food & accommodation, trainee registration with the University of the Nations, special events, training costs, speaker expenses, ministry costs and local travel costs during lecture phase and all ground fees for outreach. Outreach travel which varies greatly in price depending on the outreach location. We may use buses, trains, boats or airplanes to get to our outreach locations. Our Outreach Visa cost varies depending on your nationality and the outreach location. Our Outreach Vaccination cost will vary depending on the outreach locations and what vaccinations you already have. It is usually cheaper and easier to obtain the recommended vaccinations in your home country - see the vaccination form below.

Due Dates for Payment:

1. Due with Application: Registration fee £50 (Non-Refundable) this covers all application admin fees.

2. 1st. week of Lecture Phase
The full amount for the lecture phase is due on the start date of the School that you will be attending.

3. Week 4
Outreach fee, Airfares & Visa Fees become payable as soon tickets to your outreach location are ready to be purchased.

4. Full payment of all fees is required to be able to graduate from the School.

If you do not have the resources from which to pay your fees in full upon arrival you MUST discuss this with the school leader once you have been accepted at the earliest opportunity BEFORE coming to the school. Trainees who have not done this and who arrive here without all their fees will not be admitted into the School and will have to return home immediately.

REFUND POLICY

This is a guide for the time period and relevant amount of refund if you leave the school before it is finished.

Prior to the first class session: 100%	During the fourth week of classes: 60%
During the first week of classes: 95%	During the fifth week of classes: 50%
During the second week of classes: 85%	Beyond the fifth week of classes: 0%
During the third week of classes: 70%

YWAM Immerse Cornwall

This section explains the financial costs of attending this school. Please note that all fees are payable in British Pounds ONLY.

Lecture and Outreach:

Our costs covers amongst other things, all food & accommodation, trainee registration with the University of the Nations, special events, training costs, speaker expenses, ministry costs and local travel costs during lecture phase and all ground fees for outreach. Outreach travel which varies greatly in price depending on the outreach location. We may use buses, trains, boats or airplanes to get to our outreach locations. Our Outreach Visa cost varies depending on your nationality and the outreach location. Our Outreach Vaccination cost will vary depending on the outreach locations and what vaccinations you already have. It is usually cheaper and easier to obtain the recommended vaccinations in your home country - see the vaccination form below.

Due Dates for Payment:

1. Due with Application: Registration fee £50 (Non-Refundable) this covers all application admin fees.

2. To confirm acceptance on DTS: 10% of lecture phase fees is required as a deposit, which contributes towards your overall lecture phase fees. (Please note this is non-refundable, apart from in the instance of a visa being denied.)

3. Lecture Phase: The full amount for the lecture phase is due prior to the start date of the School that you will be attending. (Please allow 3 business days for funds to transfer.)

4. Week 8 (Lecture topic 5)

Outreach Airfares & Visa Fees become payable as soon as tickets to your outreach location are ready to be purchased.

5. Week 14 (Lecture topic 8)

Remaining outreach fees are due.

6. Full payment of all fees is required to be able to graduate from the School.

If you do not have the resources from which to pay your fees in full upon arrival you MUST discuss this with the school leader once you have been accepted at the earliest opportunity BEFORE coming to the school. Trainees who have not done this and who arrive here without all their fees will not be admitted into the School and will have to return home immediately.

REFUND POLICY

This is a guide for the time period and relevant amount of refund if you leave the school before it is finished.

Prior to the first class session*: 90%	During the fourth week: 60%
During the first week: 85% During the second week: 80%	During the fifth week: 50%
During the third week: 70%	Beyond the fifth week of classes: 0%
*100% in instance of a visa denial

YWAM Newcastle Upon Tyne

This section explains the financial costs of attending this school. Please note that all fees are payable in British Pounds ONLY.

Lecture and Outreach:

Our costs covers amongst other things, all food & accommodation, trainee registration with the University of the Nations, special events, training costs, speaker expenses, ministry costs and local travel costs during lecture phase and all ground fees for outreach. Outreach travel which varies greatly in price depending on the outreach location. We may use buses, trains, boats or airplanes to get to our outreach locations. Our Outreach Visa cost varies depending on your nationality and the outreach location. Our Outreach Vaccination cost will vary depending on the outreach locations and what vaccinations you already have. It is usually cheaper and easier to obtain the recommended vaccinations in your home country - see the vaccination form below.

Due Dates for Payment:

1. Due with Application: Registration fee £40 (Non-Refundable) this covers all application admin fees.

2. To confirm acceptance on DTS: 10% of lecture/local outreach phase fees is required as a

deposit, which contributes towards your overall lecture/local outreach phase fees. (Please note this is non-refundable, apart from in the instance of a visa being denied.)

3. Lecture/Local Outreach Phase: The full amount for the lecture/local outreach phase is due

prior to the start date of the School that you will be attending. (Please allow 3 business days for funds to transfer.)

4. Week 8 (Lecture topic 5)

Outreach Airfares & Visa Fees become payable as soon as tickets to your outreach location are ready to be purchased.

5. Week 14 (Lecture topic 8)

Remaining outreach fees are due.

6. Full payment of all fees is required to be able to graduate from the School.

If you do not have the resources from which to pay your fees in full upon arrival you MUST discuss this with the school leader once you have been accepted at the earliest opportunity BEFORE coming to the school. Trainees who have not done this and who arrive here without all their fees will not be admitted into the School and will have to return home immediately.

REFUND POLICY

This is a guide for the time period and relevant amount of refund if you leave the school before it is finished.

Prior to the first class session*: 90%	During the fourth week: 60%
During the first week: 85% During the second week: 80%	During the fifth week: 50%
During the third week: 70%	Beyond the fifth week of classes: 0%
*100% in instance of a visa denial

I agree

How much do you presently have towards school fees? (excluding pledges)

Amount needs to be in GBP (£)

How much have your church/family/friends/others pledged towards your fees?

Amount needs to be in GBP (£)

How much do you still need for your fees?

Amount needs to be in GBP (£)

How do you plan to raise the amount you still need?

List current financial obligations and how you expect to fulfil them?

Are you leaving a job to attend the YWAM?

YesNo

If you are accepted for the school, how much notice do you need to give?

Weeks

Give names of dependants you have and to what extent you are obligated to them financially?

Criminal Offences

Have you ever been charged with, cautioned or convicted in relation to any criminal offence not subject to DBS (Disclosure and Baring Service) filtering rules; or are you at present the subject of a criminal investigations/pending prosecution?

YesNo

If yes, please give details including the nature of the offences and the dates. Please give details of the court(s) where your conviction(s) were heard, the type of offence and sentence(s) received. Could you also give details of the reasons and circumstances that led to the offence(s). Continue on a separate sheet if necessary.

Have you ever been the subject of a police investigation in any country, which did not lead to a criminal conviction (not subject to DBS filtering rules)?

YesNo

If yes, please give details below, including the date of the investigation, the Police Force involved, details of the investigation and the reason for this, and disposal(s) if known.

To your knowledge have you ever had any allegation made against you, which has been reported to, and investigated by, Social Services/Social Work Department (Children’s or Adult Social Care)?

YesNo

If yes, please provide details, we will need to discuss this with you.

Has there ever been any cause for concern, any disciplinary action ever been taken against you or written warning given to you in any country, by any employer or any charitable or other organization or body working with children or young people in relation to your behaviour with children or young people?

YesNo

If YES, please give details

Declarations

I UNDERSTAND AND AGREE TO THE FOLLOWING TERMS AND CONDITIONS:

I have completed all portions of this application truthfully and to the best of my knowledge, and if accepted by Youth With A Mission Limited, I will, under God, abide by the spirit, authority and schedule of the programme.

I understand that the Discipleship Training School consists of both the lecture phase and the field placement phase, and that by completing this application, I am making a commitment to both phases of the school.

I confirm that I have read the Financial Policy Sheet and understand that payment of my school fees must be made upon or before my arrival at the school (unless prior arrangements have been made). I therefore undertake to pay all personal expenses during my involvement with YWAM.

Youth With A Mission Limited reserves the right to terminate my involvement with them, if I am found to have misled YWAM in any way or if my conduct is prejudicial to the good running of the school or to the reputation of YWAM. I have read this form and accept the terms set out in it.

In accordance with the UK Data Protection Act (1998), the information provided on my application form will be held securely, confidentially and will not be kept for longer than is necessary to achieve the stated purposes of recruitment, selection, supplementary personal details and statistics, or that required by law or our insurance company.

I agree to comply with all aspects of national and local law

RELEASE OF LIABILITY

Though every effort is made to provide a safe environment, Youth With A Mission Limited, their agents, employees and volunteer assistants are insured against loss or injury caused by the negligence of Youth With A Mission Limited.

Accordingly in the absence of any negligence or other breach of duty by Youth With A Mission Limited, participation in a Youth With A Mission Limited organised programme, event or outreach is entirely at the participant's own risk. All participants are required to have adequate medical insurance for all phases of their involvement with Youth With A Mission Limited, including repatriation for serious illness and in the case of death.

I have read and agree with the TERMS & CONDITIONS and RELEASE OF LIABILITY and I declare that I have completed this application truthfully, to the best of my knowledge.

In the event that I am unable to sign a consent form due to incapacity, I hereby give my consent for any treatment/medical intervention deemed necessary by the attending health care professionals. Whilst YWAM will make every effort to contact my next of kin/emergency contacts, there may be situations where this is not possible. I, therefore, give permission for YWAM to act in my best interests. I recognise that in an emergency situation it is standard operating procedure to always act in the interest of preserving life.

YesNo

I agree to allow Youth With A Mission to take photographs of me and my dependants and grant permission for those photographs to be used in projects, promotional materials, press articles, our website, and social medias.

YesNo

SAFEGUARDING DECLARATION

· If needed, I consent to a criminal records check if appointed to the position for which I have applied. I am aware that details of pending prosecutions, previous convictions, cautions, or bindovers against me may be disclosed along with any other relevant information, which may be known to the police.

· If needed, I understand that, if I am a UK resident, a check will be made with the Disclosure and Barring Service (DBS) and that it is an offence for any person to commence Regulated Activity without first providing a valid DBS Disclosure. If I am an overseas resident, I understand that I will need to provide a police check from my home nation if the position I am appointed to requires it.

· I agree to inform the person within the YWAM base/team responsible for processing applications for Disclosure and Barring Service checks if I am convicted of an offence after I take up any post within YWAM England. I understand that failure to do so may lead to the immediate suspension of my work with children or vulnerable adults and/or the termination of my work/training association with YWAM.

· I agree to inform the person within YWAM responsible for processing applications for the Disclosure and Barring Service if I become the subject of a police and/or a social services/(Children’s Social care or Adult Social Services)/social work department investigation.

· I understand that failure to do so may lead to the immediate suspension of my work with children or vulnerable adults and/or the termination of my work/training and association with YWAM.

I have read and agree with the Safeguarding Declaration

Due to the nature of the working and living environment for most of our YWAM teams, with staff and families with small children living in close proximity, we need to also ask you to indicate below that you are not barred from working with children/vulnerable adults.

I can confirm that I am not barred from working with children and/or vulnerable adultsI cannot confirm that I am not barred from working with children and/or vulnerable adults

Additional Medical Information

Are there additional medical issues that have arisen since your last medical was submitted to us?

PERSONAL HEALTH DISCLOSURE

Please complete all sections of this reference.
If you need more space to answer a question, please use a separate blank document or send us an email to teamplants@ywamharpenden.org saying PERSONAL HEALTH DISCLOSURE EXTRA INFORMATION
Husbands and wives must supply separate medical references
We reserve the right to ask you to have a medical reference completed by a medical doctor (or psychiatrist if appropriate), depending on the advice of our Medical Officer

YOUR HONEST INFORMATION WILL HELP US TO EFFECTIVELY ASSESS YOUR APPLICATION AND BEST CONSIDER YOUR NEEDS.

APPLICANT'S RELEASE OF MEDICAL INFORMATION

(please write your name) I,

give permission for medical information to be reviewed by YWAM's medical office (ie registered nurse, medical doctor, psychiatrist or suitably qualified allied health professional) for purposes of assessing my suitability for service with Youth With A Mission.

I give permission for the release of relevant medical information to the Youth With A Mission Medical Officer in consultation, if necessary, with the school leader only.

Position being applied for

MEDICAL HISTORY

Have you ever had or been treated for any of the following?

	Yes	No
Malaria or other tropical/infectious diseases
High blood pressure, heart problems or stroke
Arthritis or any back, muscle or joint problems
Gastic or duodenal ulcers, colitis or intestinal diseases
Epilepsy, seizures or other neurological diseases
Kidney stone or other kidney or bladder diseases
Asthma or other respiratory diseases
Diabetes
Cancer or tumours of any kind

If yes, please give details:

List all the SERIOUS ILLNESS and OPERATIONS you have had in the past. (This means any illness requiring hospital admission, treatment from your doctor for an illness lasting more than one month, or any illness that may have an affect on your health both now and in the future) Please also state the outcome and whether there are any residual problems.

Illness and Operations (Include Date and Outcome)

Describe any current medical limitations for which you are receiving treatment, or which may affect your health:

Please be aware that your living accommodation is prone to mould (especially on window frames) because of the age of our buildings and the damp climate. If you have asthma, are susceptible to respiratory problems or allergies to certain things like dust or mould, please let us know here

List any medications which you take, either on a regular basis, or only when needed and for what illness:

What if your height? please give in centimetres

click here to convert your height from another measurement

What is your weight? Please give in kilograms

click here to convert your weight from another measurement

WELLBEING

Have you experienced any of the following:

If yes, please give details

Have you ever had suicidal thoughts?

YesNo

If yes, give details here

Have you ever received professional counselling/and or phychiatric support?

YesNo

If yes, please explain

List any serious mental or physical illness in your immediate family

Is there any other information that will be helpful for us to know as we consider your application?

Disclosing information in this section does not necessarily preclude you from acceptance. These questions are to help us assess whether YWAMs lifestyle is suitable for you at the present moment.

WOMEN ONLY

Do you have any obstetric or gynecological conditions that currently affect you? (eg. Problems with past pregnancies or menstrual periods that affect your daily functioning?) If yes, please explain

VACCINATIONS

If these are not available in your country, we will require you to have them within one month of arrival, at your own expense. (This form is not complete until this section has been answered)

Due to our close living conditions, we require all staff and trainees to be up to date with their vaccinations including:

Did you complete childhood vaccines?

YesNo

Rubella (single dose) or MMR (required)

Rubella Vaccination Dates

Tetanus (required)

Tetanus Vaccination Date

(we require booster within last 10 years, especially if travelling to developing nations)

I confirm that this is a true reflection of my medical history and that failure to give any relevant information may lead to my involvement with Youth With A Mission being terminated.

MEDICAL COVERAGE IN THE UK

Please read through the following statements and select the one that applies to you

I am coming to the UK on a visa (less than six months). I understand that I will not have access to the National Health Service whilst in the UK. I am responsible for arranging medical insurance and/or travel insurance to cover these costs. I am also responsible for arranging medical and/or travel insurance for any YWAM related outreaches or trips I may take abroad to cover serious injury, repatriation, loss of passport, luggage, money etc. I absolve YWAM of all responsibility for any and all medical costs and repatriation fees.I am coming to the UK on a visa (six months or more and will pay the NHS surcharge as part of my visa fees). I understand that I will have access to the National Health Service whilst in the UK by paying this surcharge however, it will not cover prescriptions, dental, optometry or repatriation for medical reasons or in the case of fatality. I am responsible for arranging medical insurance and/or travel insurance to cover these costs. I am also responsible for arranging medical and/or travel insurance for any YWAM related outreaches or trips I may take abroad to cover serious injury, repatriation, loss of passport, luggage, money etc. I absolve YWAM of all responsibility for any and all medical costs and repatriation fees.I am a European citizen. I understand that I will have access to the National Health Service using my European Health Insurance Card (EHIC) however, it will not cover prescriptions, dental, optometry or repatriation for medical reasons or in the case of fatality. I am responsible for arranging medical insurance and/or travel insurance to cover these costs. I am also responsible for arranging medical and/or travel insurance for any YWAM related outreaches or trips I may take abroad to cover serious injury, repatriation, loss of passport, luggage, money etc. I absolve YWAM of all responsibility for any and all medical costs and repatriation fees.I am a UK citizen. I understand I will have access to medical treatment under the National Health Service. I assume responsibility for prescriptions, dental and optometry costs. I am responsible for arranging medical insurance and/or travel insurance to cover these costs. I am also responsible for arranging medical and/or travel insurance for any YWAM related outreaches or trips I may take abroad to cover serious injury, repatriation, loss of passport, luggage, money etc. I absolve YWAM of all responsibility for any and all medical costs and repatriation fees.

References

Please try and select people that have known you for at least two years and please don't choose close family members.

Church Minister or Leader Confidential Reference

First Name

Last Name

Email

Teacher/Employer Confidential Reference

If you are currently in YWAM Harpenden, your reference should be your school leader/staff or line leader.

First Name

Last Name

Email

Mature Christian Friend Reference

First Name

Last Name

Email

Review and Submit

On the next page you can review your full application. If there are any changes you need to make you will be able to go back through your application.

Once you have reviewed your application please click confirm at the bottom of the review page to send to us.

	Yes	No
Anxiety
Depression
Mood Disorders
Panic Attacks
Eating Concerns/Disorders
OCD (Obsessive Compulsive Disorder)
Self-Harm
Other mental health issues

DTS Application Form

Marital Status

Emergency Contact Information

Education and Skills

Languages

Gifts, Hobbies and Talents

Christian Life and Experience

Personal Questions

Finances

Criminal Offences

Declarations

Additional Medical Information

PERSONAL HEALTH DISCLOSURE

References

Review and Submit