Volunteer/Mission Builder Application

Volunteer Application

Please carefully fill out each of the following fields below.
Full Name

First NameMiddle NameLast Name
Date of Birth

MonthDayYear
City of Birth
Country of Birth
Country of citizenship
Passport Number
Passport expiration date

MonthDayYear
Address

Street Address

Street Address Line 2

CityState

Zip CodeCountry
E-mail
example@example.com
Phone Number

Country CodeArea CodePhone Number
Marital Status
Will any children accompany you?
Children (Name, birth date, sex):
Highest Level of Education Completed
Can you speak any other languages?
Which languages?
Desired Arrival Date

MonthDayYear
Date
Preferred length of Volunteer Service (months)
What type of volunteer service are you interested in performing? (Ex. Kid's Ministry, translating, teaching, cooking, media and communications, university ministry, etc.)
How did you first hear about YWAM Morelia?

Other

Medical Information
Emergency Contact

First NameLast Name
Emergency Contact Relationship
Emergency Contact Number

Country CodeArea CodePhone Number
Are you allergic to any medications, "Yes" or "No"? If yes, explain.
Are you currently taking any medications, "Yes" or "No"? If yes, explain.

Church involvement & References
Are you an active member of a local church? If so, please list the name of the church below.
Church Pastor's Name
Years attended
Church Phone Number

Country CodeArea CodePhone Number
Have you ever been rejected by any other Missions agency?
Reference #1 Name

First NameLast Name
Reference #1 Email
example@example.com
Reference #2 Name

First NameLast Name
Reference #2 Email
example@example.com

Final Agreements

The undersigned represents to YOUTH WITH A MISSION (herein referred to YWAM), a religious, nonprofit corporation, that he or she is of legal age; and the undersigned does hereby consent to taking part innoted activities, with full understanding insofar as such activity will involve missions, sporting activity, mingling with other individuals and groups; that there is always the risk of injury, illness, loss, possible consequent expense for medical, diagnostic and curative treatments, and incidental loss and expense; and the undersigned does for him/herself assume the risk of such incidental loss and expense, and does here by wholly release YWAM from any responsibility or liability, and waives any claims or causes of action against it or it’s agents that might arise on account of loss, injury or expense occasioned by any sort of accident or any other circumstances involving such child, and agrees to hold harmless YWAM from any responsibility of liability, and waives any claims or causes that might arise on account of loss, injury or expense occasioned by any sort of accident or other circumstance; and does hereby authorize YWAM or its staff members or other agents to arrange for and consent to X-ray examinations, anesthetic, dental, medical or surgical diagnosis, and treatment, and hold harmless YWAM from any such expense or liability. The undersigned will furnish payment or insurance for any such payment, at his or her own expense.
By checking I Agree, you hereby release Youth With a Mission, and all volunteers of any obligation due to injury, wound or loss that might occur during your participation
By checking I Agree, you hereby give consent for the administration of treatment such as anesthesia and operations if the attending physician considers it necessary.
By checking I Agree, you give permission, in case of death to be buried in the country of your service.
Should be Empty: