Documentary Filmmaking School Application 1 How To Complete This Application

INFORMATION Documentary Filmmaking School Application 1 How To Complete This Application Thank you for your interest in this school! It is our intention that the application process serve as a valuable tool in helping you, your church and us in YWAM, prayerfully evaluate whether this is the right course for you at this time. Please answer all of the questions on this application form. It will help us if you type your answer or print clearly in black or blue ink. Husbands and wives enrolling as students must complete separate application forms. If you need more space to answer a question, please use a separate piece of paper. Please note the information requested on this form is restricted to details relevant to our consideration of your application at this stage. REFERENCES Enclosed with this application are three Reference Forms to be sent to the Referees you have selected. One is for your church leader, one for a mature Christian friend, and the third is for your employer or teacher. Fill in the red sections with your name and email address and give the forms to the referees. Please ask that they return the forms directly to The Registrar as soon as possible. MEDICAL REPORT A Medical Report Form is included, part to be completed by you and part by your doctor. Please fill in the red sections yourself. PASSPORT/VISA INFORMATION This information is needed for anticipated visa purposes only, including the field placement phase of the school. ADMINISTRATION FEE A non refundable fee of 35 (which covers the cost of processing your application) should be included when you return this form. Foreign students can send this by bank draft in Pounds Sterling only or buy Pounds Sterling and send it - it seems to arrive quite safely. FINALLY... We pray that God will guide you clearly as you complete this form. 2 To Aid Your Completion of This Form Please tick the boxes after you have completed each task: Read and understood the financial policy sheet Completed and signed the application form Entered the required details on the reference forms including address of YWAM base to return form to Sent reference form to employer/teacher Sent reference form to mature Christian friend Sent reference form to Pastor/Church leader Completed personal medical detail and sent medical forms to Doctor Completed and sealed an envelope containing passport information and passport photos Included 35 application fee Now return the application pack to YWAM Harpenden. We will do our best to respond speedily. page 1 of 2

INFORMATION 3 Financial Policy INTRODUCTION This sheet is designed to explain the financial costs of attending this school and how that money is spent. It also gives a breakdown of when fees become payable. WHAT THE FEES COVER The school fees cover the cost of tuition, board and lodging during the lecture and debrief phase. In detail they cover: Student Registration with the University of the Nations Speaker expenses (travel and a small honorarium) Food for all meals Internal rental costs for the use of base accommodation and teaching rooms Travel costs for midweek and mid-term outreaches Contribution towards the running of the training office Contribution towards the cost of one pastoral visit per outreach location No school staff member receives any income from the school. APPROXIMATE OVERALL COSTS Second Level School Please see individual schools page at www.ywamharpenden.org for costs In addition to the above you should allow some money for leisure etc. SUMMARY - DUE DATES FOR PAYMENT Registration fee - 35 due with application (Covers the cost of processing your application.) Balance of Lecture and Debriefing phase fee due on arrival. Second Level School - 60% on arrival, complete payment by week 6. Outreach fee - Visa, vaccination and flight costs all become payable at the time of purchase - normally from week 5. COSTS FOR CHILDREN Fees for children are based mainly on food costs but also include a nominal amount for utilities. Age Cost 0-2 Free 3-4 240 5-11 390 12-17 600 SPECIAL CIRCUMSTANCES Youth With a Mission is a faith mission. Therefore we are open to prayerfully considering applications from those who through unemployment or other circumstances are lacking the total finances. If, together with the church, we felt it right that they are to attend the school we would work out a financial scheme on an individual basis. Without such an arrangement in place before the school starts we are unable to accommodate students who do not have their fees in full. Please do not hesitate to contact us if this applies to you. PAYMENT IMPORTANT - ALL FEES ARE PAYABLE IN POUNDS STERLING ONLY. For overseas applicants please arrange payment by Sterling Bank Draft payable on a UK clearing bank. Payments can also be made online at www.ywamharpenden.org/payment HELP If you have any questions or if anything is unclear please contact the School Leader. page 2 of 2

Year of school applying for: Name DFS APPLICATION Documentary Filmmaking School Application 1 PERSONAL INFORMATION Name: Title First Name Middle Name Last Name Preferred Name Gender: Male Female Date of birth: Nationality: Email: Daytime Phone Number: Country Code Area Code Phone Number Evening Phone Number: Country Code Area Code Phone Number Mobile Phone Number: Country Code Area Code Phone Number Current Address: Street Address Street Address Line 2 Town/City County/State Postal/Zip Code Country Permanent Address (if different from above): Street Address Street Address Line 2 Town/City County/State Postal/Zip Code Country 2 MARITAL STATUS Single Engaged Married Separated Divorced Widow/er Spouse/Fiancé s Name: First Name Middle Name Last Name Preferred Name Are you coming with your Spouse/Fiancé? Yes No If not, please comment: Is your Spouse/Fiancé also applying for the school? Yes No page 1 of 6

DFS APPLICATION 3 Dependents Will any children be accompanying you? Yes No Name Birth Date Gender: Male/Female 4 DTS Information Have you done a Discipleship Training School? Yes No Where did you do your DTS? Base name and Country What date was your DTS? What was your DTS leaders name? First Name Email: Last Name 5 Church Information Church Affiliation: Church Leader s Name: Prefix First Name Last Name Church Leader s Title: Home Phone Number: Work Phone Number: Church Leader s Email: Country Code Area Code Phone Number Country Code Area Code Phone Number Mobile Phone Number: Country Code Area Code Phone Number Church Address: Street Address Street Address Line 2 Town/City County/State Postal/Zip Code Country Does your church support the idea of you attending a Youth With A Mission (YWAM) School? Yes No Don t Know Comments: page 2 of 6

DFS APPLICATION 6 Education and Skills Secondary School (Education between 11 and 18 years) Name of Establishment Dates Attended Exam Success/ Qualifications Received University/College/Higher or Further Education (post 18 years) Name of Establishment Dates Attended Exam Success/ Qualifications Received List any other training or qualifications you have received: What is your employment History and Occupation? Position: Employment Length: Briefly describe what your work entails: Briefly describe other past work experiences: 7 Languages Please identify the languages you speak and indicate your proficiency: 1 - mother tongue 2 - native tongue proficiency 3 - full professional proficiency 4 - conversational proficiency 5 - limited proficiency English Proficiency Other Languages and Proficiency page 3 of 6

DFS APPLICATION 8 Gifts and Hobbies Please indicate your gifts including any drama, musical or artistic talents you have, as well as your hobbies. Gifts: Hobbies: Please describe any achievements you feel are highlights over your lifetime so far: 9 Christian Life and Experience Please prayerfully answer the following questions, briefly, on a separate piece of paper (you may print or type) and attach this to your application form, or email it to us together with the first half of your application. 1. Describe your conversion experience or explain how God became real and personal to you. 2. What experience do you have with sharing your faith? 3. What church involvement have you had? 4. Have you had any leadership experience? 5. Briefly describe any experiences you have had in other cultures. Where are you at currently? 6. How would you describe your Christian life and your relationship with God at the present time? 7. Do you feel God has called you into some kind of full time Christian service? Please explain. 8. How might you see using your skills/gifts/training in a missions context? 9. How did you hear about YWAM and this particular school? 10. Why do you want to do the documentary filmmaking school? 11. What are your hopes and expectations for yourself during this school? 12. Name one documentary film that has impacted you and explain why? 13. In your understanding, what is documentary fimmaking? 14. This school requires basic knowledge and skills in communication and video production, describe your experiences so far: 15. The school is very demanding and lots of hard work, do you think you would cope with these challenges? 16. How do you think you would cope with challenging situations like: different food and culture, dormitory housing or small quarters for families? 17. Have you had any previous YWAM involvement? If so where and when? page 4 of 6

DFS APPLICATION 10 Finances We expect all our trainees to come with payment of all school fees upon or before arrival at the school (unless prior arrangements have been made). All financial amounts need to be in GBP ( ) How much do you presently have towards school fees? (excluding pledges) How much have your church/family/friends/others pledged towards your fees? How much do you still need for your fees? 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 School? Yes No If you are accepted for the school, how much notice do you need to give? Give names of dependants you have and to what extent you are obligated to them financially? Are there any current personal issues which would be relevant to this application that you would like to share with us? 11 Criminal Offences Have you ever been cautioned, charged or convicted of a criminal offence in any country, or do you have any cases pending? Yes No If Yes, please explain: 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: Has any allegation ever been made against you which has been reported to, and investigated by Social Services/The Social Work Department in any country? Yes No If Yes, please explain: page 5 of 6

DFS APPLICATION 11 Criminal Offences (cont) Has any disciplinary action ever been taken against you or written warning given in any country, by any employer or any charitable or other organisation or body working with children or young people in relation to your behaviour with children? Yes No If Yes, please explain: 12 Liability, Consent, Commitment and Termination of Involvement 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. Applicant s Signature: CONSENT FOR TREATMENT - an emergency provision Date: 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. Applicant s Signature: COMMITMENT Date: 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. Applicant s Signature: TERMINATION OF INVOLVEMENT Date: 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 from and accept the terms set in it. Applicant s Signature: Date: page 6 of 6

TEACHER/EMPLOYER REFERENCE Teacher/Employer Confidential Reference You have been selected as a teacher/employer reference by a YWAM Harpenden school applicant. Please complete this form and send it back to us as soon as possible so we can process their application. Thank you! To find out more about YWAM Harpenden please visit: http://www.ywamharpenden.org/about-ywam-harpenden/ If you have any questions please email registrar@ywamharpenden.org or call +44 (0)1582 463300 1 Applicant Details Name of Applicant: Applicants Email: School Applied For: Start Date 2 Personal Profile Please assess the applicant on the qualities listed below according to the evaluation system: 1 - Usually 2 - Often 3 - Sometimes 4 - Rarely Initiator Social adaptability Emotional stability Leader Team worker Co-operative Reliable Disruptive Teachability Resilience 3 Ability to Work in Teams The applicant will be living and working closely with others for an extended period. Please answer/comment on the following. The applicants attitude towards work: The quality and character of his/her work: The applicant s maturity in making judgements: The applicants ability to be part of a team: The applicants ability to handle conflict: Have we overlooked anything which you consider relevant to this application? page 1 of 2

TEACHER/EMPLOYER REFERENCE 4 Relationship to Applicant How long have you known the applicant? Years I know the applicant Very Well Quite Well A Little Very Little What is your relationship with the applicant? (e.g. teacher / employer) Do you think participation in YWAM would be beneficial for the applicant? Yes Yes (with reservations) No If you have reservations, your comments would be helpful: 5 Your Information Name: Email: First Name Middle Name Last Name Address: Street Address Street Address Line 2 Town/City County/State Postal/Zip Code Country Phone Number: Country Code Area Code Phone Number I declare that the information given on this form is correct to the best of my knowledge and belief. Signature: Date: Thank you for filling in this reference form. Please send this form to: YWAM Registrar Discipleship Training School 6 Highfield Oval Harpenden Herts AL5 4BX United Kingdom or email to: registrar@ywamharpenden.org page 2 of 2

CHURCH MINISTER/LEADER REFERENCE Church Minister or Leader Confidential Reference You have been selected as a church minister/leader reference by a YWAM Harpenden school applicant. Please complete this form and send it back to us as soon as possible so we can process their application. Thank you! To find out more about YWAM Harpenden please visit: http://www.ywamharpenden.org/about-ywam-harpenden/ If you have any questions please email registrar@ywamharpenden.org or call +44 (0)1582 463300 1 Applicant Details Name of Applicant: Applicants Email: School Applied For: Start Date 2 Personal Profile Please assess the applicant on the qualities listed below according to the evaluation system: 1 - Usually 2 - Often 3 - Sometimes 4 - Rarely Initiator Social adaptability Emotional stability Leader Team worker Co-operative Reliable Disruptive Teachability Resilience Comments: 3 Ability to Work in Teams The applicant will be living and working closely with others for an extended period. Please answer/comment on the following. The applicants motive for getting involved with missions: Do you foresee any difficulties that could compromise their Christian sexual morality? Yes No Comments: (if necessary) The applicants ability to be part of a team: The applicants ability to handle conflict: page 1 of 3

CHURCH MINISTER/LEADER REFERENCE 3 Ability to Work in Teams (Cont) The applicant may sometimes have to make difficult personal decisions under stressful conditions - (e.g. to stay when feeling homesick, to eat or travel when not feel well.) Is he/she able to take input from others when decision making? Yes No Comments: (if necessary) 4 Christian Background Please comment briefly on: The applicants growth as a Christian: The quality and extent of his/her Christian service: Do you know the applicants family? Yes No Is there anything you think would be helpful for us to know about them? 5 Relationship to Applicant How long have you known the applicant? Years I know the applicant Very Well Quite Well A Little Very Little What is your relationship with the applicant? (e.g. Church Minister/Leader) Do you think participation in YWAM would be beneficial for the applicant? Yes Yes (with reservations) No If you have reservations, or say no please comment: 6 Your Information Name: First Name Middle Name Last Name Email: Address: Street Address Street Address Line 2 Town/City County/State Postal/Zip Code Country page 2 of 3

CHURCH MINISTER/LEADER REFERENCE 6 Your Information (Cont) Phone Number: Country Code Area Code Phone Number I declare that the information given on this form is correct to the best of my knowledge and belief. Signature: Date: Thank you for filling in this reference form. Please send this form to: YWAM Registrar Discipleship Training School 6 Highfield Oval Harpenden Herts AL5 4BX United Kingdom or email to: registrar@ywamharpenden.org page 3 of 3

FRIEND REFERENCE Mature Christian Friend Confidential Reference You have been selected as a Christian Friend reference by a YWAM Harpenden school applicant. Please complete this form and send it back to us as soon as possible so we can process their application. Thank you! To find out more about YWAM Harpenden please visit: http://www.ywamharpenden.org/about-ywam-harpenden/ If you have any questions please email registrar@ywamharpenden.org or call +44 (0)1582 463300 1 Applicant Details Name of Applicant: Applicants Email: School Applied For: Start Date 2 Personal Profile Please assess the applicant on the qualities listed below according to the evaluation system: 1 - Usually 2 - Often 3 - Sometimes 4 - Rarely Initiator Healthy Loner Worrier Leader Team Worker Aggressor Co-operative Reliable Disruptive Enthusiastic Energetic 3 Ability to Work in Teams The applicant will be living and working closely with others for an extended period. Please answer/comment on the following. The applicants motive for getting involved with missions: Do you foresee any difficulties that could compromise their Christian sexual morality? Yes No Comments: (if necessary) The applicants ability to be part of a team: The applicants ability to handle conflict: The applicant may sometimes have to make difficult personal decisions under stressful conditions - (e.g. to stay when feeling homesick, to eat or travel when not feel well.) Is he/she able to take input from others when decision making? Yes No Comments: (if necessary) page 1 of 3

FRIEND REFERENCE 4 Christian Background Please comment briefly on: The applicants growth as a Christian: The quality and extent of his/her Christian service: Do you know the applicants family? Yes No Is there anything you think would be helpful for us to know about them? 5 Relationship to Applicant How long have you known the applicant? Years I know the applicant Very Well Quite Well A Little Very Little What is your relationship with the applicant? (e.g. Church Minister/Leader) Do you think participation in YWAM would be beneficial for the applicant? Yes Yes (with reservations) No If you have reservations, or say no please comment: 6 Your Information Name: Email: First Name Middle Name Last Name Address: Street Address Street Address Line 2 Town/City County/State Postal/Zip Code Country Phone Number: Country Code Area Code Phone Number I declare that the information given on this form is correct to the best of my knowledge and belief. Signature: Date: Thank you for filling in this reference form. page 2 of 3

FRIEND REFERENCE Please send this form to: YWAM Registrar Discipleship Training School 6 Highfield Oval Harpenden Herts AL5 4BX United Kingdom or email to: registrar@ywamharpenden.org page 3 of 3

Medical Confidential Reference MEDICAL REFERENCE Please answer all the questions on this medical reference form. It will help us if you type your answers or print carefully in black/blue ink. Husbands and wives must supply separate medical references. If you need more space to answer a question, please use a separate piece of paper. To The Applicant: Please complete section 1-6 of this reference yourself. Then take it to your General Practitioner or other Doctor who has recently looked after you and have him/her complete section 7. (You are responsible for any fees that your doctor may charge for this service). 1 Applicant Details Name of Applicant: Title First Name Middle Name Last Name Date of Birth: NHS No. (British): Current Address: Street Address Street Address Line 2 Town/City County/State Postal/Zip Code Country School being applied for: Start Date: 2 General Health Are you able to walk up to six miles (10 kilometres) in one day? Yes No If this is a problem, please explain: Are you able to carry out reasonably strenuous physical work? Yes No If no, please explain: Are you presently in good health? Yes No If no, please give brief details: page 1 of 4

MEDICAL REFERENCE 3 Medical History Please answer the following questions as fully as possible: List all 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 which may have an effect on your health both now and in the future.) Please also state the outcome and whether there are any residual problems: Illness/Operation Date Outcome List any SERIOUS MENTAL or PHYSICAL ILLNESS in your IMMEDIATE FAMILY: Illness Family Member Describe any CURRENT MEDICAL PROBLEMS for which you are receiving treatment, or which may affect your health: List any MEDICATIONS which you take, either on a regular basis, or only when needed: What is your height? feet inches (or meters) What is your weight? stone lbs (or kilograms) Describe any current psychiatric problems for which you are receiving treatment or have received treatment in the past (eg. anxiety, depression, panic attacks, eating disorders, other psychiatric disorders): Is there any other information which will be helpful for us to know as we consider your application? 4 Inoculations Due to our close living conditions, we require all staff and trainees to be up to date with their inoculations including: Rubella (single dose): Yes No Date of vaccination: Tuberculosis - TB (single dose): Yes No Date of vaccination: Tetanus (every 10 years): Yes No Date of vaccination: If these are not available in your country, we will require you to have them within one month of arrival, at your own expense. page 2 of 4

MEDICAL REFERENCE 5 For Women Only Do you have any gynaecological problems that still affect you? (eg. Problems with past pregnancies or menstrual periods?) Please explain: 6 Applicant s Release of Medical Information I, (applicant s name), give permission for medical information to be reviewed by a registered nurse or medical doctor, or suitably qualified allied health professional for purposes of assessing my suitability service with Youth With A Mission. I give permission for the release of relevant medical information to Your With A Mission medical officer in consultation, if necessary, with the personnel manager or team leader only. Signature: Date: When you have completed the above sections, please take the whole medical reference to your doctor and ask him/her to complete their section. Then please return the completed reference to us at the address at the end of this form. 7 Medical Reference to be Completed By the Doctor Who Holds Your Medical Records Name of Applicant: First Name Middle Name Last Name Would you please verify the medical history as supplied by the applicant and make any additions or comments as appropriate. The purpose of this report is to assess suitability for service with Youth With A Mission England and Wales, which may include brief trips to locations anywhere in the world. Please make any comments or additions on: Past history Relevant family history Current medication Weight and general fitness General Health Please give details if the applicant has had any problems with: Epilepsy or fits Anaemia or blood disorders page 3 of 4

MEDICAL REFERENCE 7 Medical Reference to be Completed By the Doctor Who Holds Your Medical Records (Cont) Hypertension or heart disease Endocrine disorders Psychiatric problems - including depression, anxiety and eating disorders Adverse reactions to stressful situations Is the applicant free from infectious diseases? Has the applicant had any allergic reactions? Is there any relevant information which we need to know before accepting the applicant? In your professional opinion, is this person suitable for service in Youth With A Mission? Yes (with no reservations) Yes (with limitations) No If limitations, please explain: Doctor s Signature: Name and Address (or practice stamp) Date: Thank you for filling in this reference form. Please send this form to: YWAM Registrar Discipleship Training School 6 Highfield Oval Harpenden Herts AL5 4BX United Kingdom or email to: registrar@ywamharpenden.org page 4 of 4

Passport / Visa Information PASSPORT AND VISA INFORMATION School applying for: Please send 3 (three) passport size photographs with this form. Please send this document, completed and with photos, in a separate, sealed envelope and send it to the address at the bottom of this form. It is NOT part of the application process. Please attach one of your photographs here Please note: You must have a passport valid for at least six months after the end of the school/outreach phase for visa application purposes. Name as listed on passport: Title First Name Middle Name Last Name Date of birth: day / month / year Place of birth: City Country Citizenship/nationality: Passport Number: Place of issue: Date of issue: Date of expiry: City day / month / year day / month / year Country Please send this form to: YWAM Registrar Discipleship Training School 6 Highfield Oval Harpenden Herts AL5 4BX United Kingdom page 1 of 1