Greetings from the UofN Student Mobilization Centre of YWAM aka YWAM Converge:

Greetings from the UofN Student Mobilization Centre of YWAM aka YWAM Converge: We sincerely appreciate your interest in joining staff at the UofN Student Mobilization Centre/YWAM Converge. The staff application you is attached. If you have any questions, please feel free to contact me at (608)239-1642, or e-mail me at john.henry@uofn.edu The following is important information and guidelines concerning the application. The application is lengthy, so please take your time in filling it out. Feel free to use extra paper to answer questions if the space provided is inadequate. Once your application is received, we can discuss your particular role. Together, we will create your job description and post your photo and role, including fundraising campaign page, on the SMC and YWAM Converge web sites. Thank you again for your interest in the UofN Student Mobilization Centre/YWAM Converge. May God bless you and guide you clearly as you take steps to obey Him! We sincerely hope you find our international network and YWAM community a good fit for you and you to us! Yours in Christ, John Henry

INSTRUCTIONS Detach the YWAM Leader Reference and the Pastor//Elder Reference forms and forward them to your selected references, after filling in the top section of each form. We cannot begin to process your application until both forms are returned to us. It is your responsibility to follow up with your references to make sure they return the forms in a timely manner. Reference forms are confidential therefore, please do not read them yourself. Please make your references aware that we may call them to talk about the reference they submitted. The Memorandum of Agreement must be signed. Please read through this carefully, because this is where you make a two-year commitment to YWAM-SMC. The Memorandum of Agreement is our proof (should it ever be required) to the Internal Revenue Service that our staff members have made long-term (two-year) commitments. With this, we can process your donations/financial support (upon acceptance) and your supporters will receive a tax deduction for their contributions. In addition to signing the Memorandum of Agreement, you will sign a Salary Cap agreement, a Burial Agreement, a Health Form and a Financial Form. Please complete the financial forms to the best of your ability, even if you are just now beginning the process of support raising. Converge believes having adequate support is vital to a successful start as a full-time missionary. Each YWAMer is required to raise his/her own support from churches, family and friends. Though we do not require it, we strongly recommend that a single person raise a minimum of $1800 per month in committed support. Couples need a minimum of $2,500 per month. This figure should cover the typical requirement for housing/rent, utilities, meals, phone/internet service, gas, car insurance, life & medical insurance, vacation, ministry expenses including travel, etc. Please use the budget tool included in this staff application packet. Occasional part-time or seasonal employment may be necessary, however part-time jobs should not exceed 20 hours/week or supersede regularly scheduled YWAM Converge/SMC meetings and events. The Salary Cap provides a limit the total annual financial contributions as an employee of the YWAM Converge/SMC. The Salary Cap will be set according to your role, requirements for travel, your family/ dependents, and the location in which you live and work. Board approval will be required for special circumstances when funds raised exceed the Salary Cap. If you need some time to raise your support, please keep your ministry leader and the YWAM Converge Office informed of your progress on a regular basis. If you have not yet taken the School of University Ministries & Missions (SUMM) or our Student Missions Leadership Seminars, you will be classified as Staff-in-Training until your SUMM & outreach or Student Missions Leadership Seminar is completed. After acceptance as Staff-in-Training, you should plan on doing the next available SUMM or Student Missions Leadership Seminar. The Student Missions Leadership Seminars is a 3 week seminar, the SUMM is a 3 month lecture phase with an 8-12 week internship. Please clip a recent passport size photo of yourself to your Application Form not smaller than 1 1/2 x 2 inches. When the application is completed, please return it to the YWAM Converge Office. Once the application and two reference forms are received, the application will be processed by the YWAM Converge Office and your immediate SMC regional leader for a decision. You will be notified of the results by either the YWAM Converge Office or a SMC ministry leader. You may photocopy this page.

YWAM Converge STAFF APPLICATION Youth With A Mission (YWAM) To Know God and To Make Him Known ABOUT YWAM It began in 1960 with an ordinary young man and an extraordinary vision. Loren Cunningham described it as a waking dream. He saw a map of the world with waves crashing onto the continents, advancing inland until all the nations were covered. Loren says, As I watched, the waves became young people of all races...talking to people on street corners and outside bars. Going from house to house. Helping the lonely and the hungry. Caring for people everywhere they went... That God-given vision has become a reality. Loren started YWAM in 1960. Since then, thousands have been involved worldwide in fulfilling Christ s commandment to, Go into all the world and preach the Gospel to every creature (Mark 16:15) THE YOUTH WITH A MISSION TRIBE YWAMers are all ages --young people, families, and retired persons. We come from many ethnic and educational backgrounds, from many denominations and countries. We love Jesus and thank God for allowing us to play a part in helping to fulfill the Great Commission. YWAM has over 15,000 staff and annually trains approximately 25,000 shortterm workers to minister in over 1000 operating locations in 140 countries. Three-fold thrust There are three main ways we are involved in the goal of taking the Gospel to all the world: Evangelism -spreading God s message, Training - preparing workers to reach others, and Mercy Ministries-showing God s love through practical assistance. These three ministries are carried out in many different ways by the basic unit of YWAM --teams, which can be small or large, mobile or localized, made up of short-term volunteers or long-term staff. Each of these teams is committed to a specific goal of evangelism, training or mercy ministry, working in cooperation with local churches and sister organizations. YWAM STATEMENT OF PURPOSE Youth With A Mission is an international movement of Christians from many denominations dedicated to presenting the Gospel of Jesus Christ personally to this generation, to mobilize as many as possible to help in this task, and to the training and equipping of believers for their part in fulfilling the Great Commission. As Christians for God s Kingdom, we are called to love, worship, and obey our Lord, to love and serve His Body, the Church, and to present the whole Gospel for the whole man throughout the whole world. We of YWAM believe that the Bible is God s inspired and authoritative Word, revealing that Jesus Christ is God s Son, that man is created in God s image, that He created us to have eternal life through Jesus Christ, that although all men have sinned and come short of God s glory, God has made salvation possible through the death on the cross and resurrection of Jesus Christ, that repentance, faith, love and obedience are fitting responses to God s initiative of grace towards us, that God desires all men to be saved and to come to the knowledge of the truth, and that the Holy Spirit s power is demonstrated in and through us for the accomplishing of Christ s last commandment, Go ye into all the world and preach the Gospel to every creature (Mark 16:15).

YWAM Converge STAFF APPLICATION ABOUT THE UOFN STUDENT MOBILIZATION CENTRE The UofN Student Mobilization Centre is an international network equipping student workers and mobilizing student teams to serve cross-cultural missions projects.the SMC is fostering a global movement of university students who are serving Christ's Great Commission through their life-work. We believe this generation is ready for new ways, new paradigms, and a new heart to make a difference in a world that cries out for mercy, for hope, and for healing. We see student volunteers and mobilizers everywhere. They are the new international community of students and young adults seeking God for justice, for revelation, and for real transformation. SMC DECLARATION We commit to work with God, challenging this generation of university students in every nation to go to the uttermost parts of the world, expressing the nature and character of God through their calling and life s work. Responding to the call to disciple all nations, we are determined to be and do all that God requires to disciple and mobilize students, equipped in their fields, to transform all nations for the glory of the Lord. To accomplish this, three types of SMC programs are available: Converge Internships: a principal program of the UofN SMC is for short-term teams of university student volunteers who serve communities in long-term projects at various levels of development. Seminars: these 1- to 6-week specialized training modules are designed for both students and leaders. Current seminars include: Student Ministries Leadership (SML), Foundations for Biblical Christianity (FFBC), and the Vision Leadership Training Course (VLTC). The School of University Ministries and Missions, a 12- week course designed to equip YWAM staff and UofN students. This course is followed by a project/internship, which you design and which must be completed within 12 months of the completion of the lecture phase. All SMC programmes and resources are designed to: Present the gospel to students through a variety of ministries and media. Disciple students by modeling a godly lifestyle and by providing various training opportunities - primarily in a livelearn environment. Reveal the thrill and wonder of hearing God s voice and interceding for the nations. Serve student needs through lasting friendship and caring community, especially international students. Impart an understanding that God is central to the learning process and that He is with them in the difficult questions that challenge their faith. Encourage students to serve God s purposes, using their university training while expressing the knowledge of God in every arena of society. Partner to serve the needs of communities through YWAM ministries, churches, and other organizations internationally. Proclaim that the university is a key doorway for the Body of Christ to reach and teach the nations - especially through ministry to international students from creative access nations. Integrate the diverse programs of YWAM and U of N, especially the Discipleship Training School, so as to present them in university communities around the world.

YWAM Converge STAFF APPLICATION Page 1 Date of Application: **(DTS is a prerequisite for all staff positions)** Area of service applying for (please be specific about role/location): PERSONAL INFORMATION Last/Family Name: First: Middle Name: Current Address: City: State/Province: Country: Postal/Zip Code: This Address Until: (mm/dd/year) Permanent Address: City: State/Province: Postal/Zip Country: Male Female Date of Birth: (mm/dd/year) Age: Birthplace: Nationality: Email: Fax: Phone Number (please circle - home or cell): FAMILY INFORMATION Marital Status (check all that apply): Single: Engaged: (Date ) Married: (Date ) Separated: (Date ) Widowed: (Date ) Divorced: (Date ) Remarried: (Date ) SPOUSES INFORMATION: First: Last/Family Name: Middle: Male Female Date of Birth: (mm/dd/year) Age: Birthplace: Nationality Number of Dependent Children Accompanying You: Dependent Child #1 Full Name: Male Female Date of Birth: (mm/dd/year) Age: Birthplace: *Please list any other dependent children on a separate page. EMERGENCY INFORMATION IN CASE OF EMERGENCY, CONTACT: Relationship: Full Name: PO Box /Street Address: City: State/Province: Postal/Zip Code: Email: Phone Number (please circle - home or cell): HOME CHURCH Church Name: Pastor s Name: Email: Denomination: PO Box /Street Address: Country:- Phone: Fax: You may photocopy this page.

YWAM Converge STAFF APPLICATION page 2 EDUCATIONAL INFORMATION I have have not completed high school/secondary school. Highest educational level completed: Most Recent School Name: City: Dates Attended: From To I have a GED/ High School/ Secondary School/ College/ University/ Seminary (circle one) Attended: Name: City: Dates Attended: Major: Degree Graduated With: Do you intend to complete a degree with the University of the Nations? Yes No PASSPORT/VISA INFORMATION PASSPORT - Name as listed on passport: (Last/First/Middle) I have a valid passport or I applied for a new passport on: (mm/dd/year) Passport #: Passport Expiry Date: (mm/dd/year) Birthplace City: State/Prov: Country: City and Country Where Passport Was Issued Country/Countries of Citizenship: VISA - Type: Date Visa Issued: (mm/dd/year) Visa Expiration Date: (mm/dd/year) City and Country Where Visa Issued: Non-U.S. staff only: Have you ever been refused a visa? No Yes. Give nation and details: PREDOMINANT ETHNIC BACKGROUND Please specify ethnic background: LANGUAGES English Proficiency (please indicate proficiency using the number scale below. e.g. English-6): 1. Elementary Speaking 2. Limited Word Proficiency 3. Minimum Professional Proficiency 4. Full Professional Proficiency 5. Native Speaking Proficiency 6. Mother Tongue First Language: Second Language: Third: Other: PAST EMPLOYMENT HISTORY (List most recent jobs first): From Date: to: Employer: Position: Supervisor: Tel: From Date: to: Employer: Position: Supervisor: Tel: From Date: to: Employer: Position: Supervisor: Tel:

YWAM Converge STAFF APPLICATION page 3 YWAM WORK EXPERIENCE Have you ever been on YWAM staff? Yes No (If yes, please list below.) Name of current YWAM Leader: Location: Email: YWAM Base and/or Ministry Web site(s): Previous Location: Job Title: Ministry Leader: Please list any other YWAM staff positions on a another sheet of paper. YWAM U of N SCHOOL EXPERIENCE Date you completed the DTS: At which YWAM location: Date you completed the SUMM: At which YWAM location: Date you completed the SML: At which YWAM location: Have you completed any other secondary YWAM or U of N school(s)/seminars? Yes No (If yes, please list below) Course Name: Location: Leader: Lecture Phase Dates: Field Assignment Location: Course Name: Location: Leader: Lecture Phase Dates: Field Assignment Location: Please list any other YWAM schools/seminars on a another sheet of paper. MINISTRY INTEREST & INDIVIDUAL EXPERIENCE Please check the areas you have experience and list details: Administration/Bookkeeping: Teaching/Presenting Fundraising/Development Personnel/Visas Child care &/or Cooking/Menu Planning Hospitality Event planning Mobile/Communications Team Speaker translation (list languages) Computer technology/lan Web site design/social Networking Photography/Graphics Video/film editing Audio/podcasting Writing/editing: Ministry News/Blogs Please check the areas you would be interested in working and comment: Communications: Photography/graphics Speaker translation (list languages) Computer technology/lan Web site design/social Networking Video/film editing Audio/podcasting Writing/editing: Ministry News/Blogs Mobile/Communications Team

YWAM Converge STAFF APPLICATION page 4 Student Internship Team - Design, Recruitment, and Oversight Administration Field Project Interface / Internship Team Design University Community Interface / Internship Team Recruitment Internship Team Oversight Seminars & Schools University DTS School of University Ministries & Missions Student Ministries Leadership Seminar Vision Leadership Training Seminar Discipleship Seminar for University Students Speaker translation (list languages) YWAM Converge Office: Study, Library, & Resource Centre Librarian Fund raising/development Bookkeeper Hospitality Pioneering University Ministries Mobile Research/ Prayer / Recruiting Team Campus Group Leadership International Student Ministries University Community Interface / Internship Team Recruitment Innovations Research & Prayer Trips Conferences & Event Planning Short-term outreaches for church and campus leaders Has anyone from SMC Recruited you? If so, who and for what area of service? BACKGROUND: Please answer the following questions describing your desire to be a part of YWAM Converge/SMC. Please use a separate paper if necessary. 1. How did God call you personally to missionary service? 2. (For families) How did God call your family into missionary service? 3. How does your immediate family feel about your decision to enter into missions? 4. What influenced you to apply for staff with UWAM Converge/SMC? 5. Have you worked with other cultures, races, and/or religions? No Yes if yes, please explain and give details: 6. What are your spiritual/ministry/missionary goals? 7. Are there any traumas, issues, situations which may affect your calling and commitment to YWAM Converge/SMC (legal proceedings, domestic/family matters, divorce, separations, deaths)?

YWAM Converge STAFF APPLICATION page 5 SIGNATURE FORM 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. Applicant's Signature Date RELEASE OF LIABILITY I/We do hereby release Youth With A Mission, its staff, agents and volunteer assistants 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 Youth With A Mission. Should any situation occur that requires legal action, I/we agree to binding arbitration (When a Staff/staff with a UofN Student Mobilization Centre program field assignment, you will be enrolled in our short-term Staff travel insurance.) Applicant's Signature Date If I am accepted, I will abide by the Spirit, rules, and schedule of the UofN Student Mobilization Centre of YWAM, Inc. (aka YWAM Converge) Applicant's Signature Date STATEMENT OF BURIAL AND MEDIATION We at Youth With A Mission, 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 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, in that we believe it is not the final step, but just a passage. The person is not in the coffin, but only his/her earthly shell. Therefore the priority for limited resources on outreach must be for living. In the case of death, YWAM cannot commit to cover the expenses of burial or transport home from the country of death (developed or nondeveloped 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. I agree that in the case of my death while on outreach in conjunction with Youth With A Mission, that they may carry out the burial in the location of my death. 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, its staff and associates, from any responsibility for burial costs. Printed Name: Applicant s Signature: Date:

YWAM Converge STAFF APPLICATION page 6 FINANCIAL INFORMATION FORM ESTIMATED MONTHLY EXPENSE WORKSHEET FOR YWAM/SMC CONVERGE STAFF We believe having adequate financial and prayer support is vital to a successful start as a full-time missionary. If you need some time to raise your support, please keep the YWAM Converge Office informed of your progress on a regular basis. The following is a tool with estimated amounts for creating your personal budget. Personal Expenses: Housing: Rent Own Share Rent with Others. Groceries & Household Supplies: (Min. $200 Single Person.) Tithe/offerings (10% of income, plus offerings) Taxes (self-employed) Clothing (recommended-$20-$50) Laundry ($10-$20) Household items ($20-up) Auto (gas & repairs ($80-$150) Health/Auto Insurance ($100-$500) Ministry Expenses: Support raising travel ($10-$100) Newsletter/postage ($5-$20) Outreach/airfare ($60-$150) Medical/prescriptions ($5-up) Gifts/Christmas/B-days ($15-$30) Entertainment/dining out ($30-up) Miscellaneous cash ($20-up) Medical/prescriptions ($5-up) Gifts/Christmas/B-days ($5-$20) Entertainment/dining out ($10-up) Miscellaneous cash ($10-up) Other Possible Expenses Current debt Car payment Training/seminars Children s education Internet service Life Insurance Savings/IRA Vacations/Travel Other Total expenses PLEASE ANSWER ALL OF THE FOLLOWING QUESTIONS: Do you have the committed financial support base to enable you to fulfill your intentions to YWAM Converge/ SMC? Yes No If no, how much more monthly support do you need to raise? What specific plans do you have to make up the difference? If your application is accepted, how long will it take to raise your support? Do you currently have any outstanding debt for: 1. YWAM Schools/Outreaches? Yes No If Yes, amount 2. Credit Cards, Car Payments, Other Debts? Yes No If Yes, amount How do you plan on meeting those obligations after joining YWAM Converge/ SMC staff? Do you need information to raise your support? Yes No Now that you have completed the financial worksheet, please fill in the following blanks: Your grand total monthly budget. $ Your committed monthly support from Church, family, & friends. Your immediate fundraising goal.

YWAM Converge STAFF APPLICATION PASTOR CONFIDENTIAL REFERENCE FORM TO THE APPLICANT Fill in the above and give to your Pastor or Pastoral Leader. You should provide a stamped addressed envelope for the person filing this reference. Address envelope to: YWAM Converge/SMC, P.O. Box 1526, Ocean City, NJ 08226 USA -or- Email to: admin@ywamconverge.org First: Last/Family Name: Middle: Current Address: City: State/Province: Postal/Zip Code: Country: Phone Number: Email: I, the above named applicant, WAIVE any right to have or obtain copies of this recommendation. Applicant s Signature: Date: The above applicant has applied for staff with Youth With A Mission (YWAM), an international, interdenominational Christian missionary organization. YWAM, founded in 1960, now has centers in over 1,000 locations on all 6 continents. Its purposes include training, challenging and mobilizing Christians to fulfill Christ s command: Go, therefore, and make disciples of all nations. Serious consideration will be given to your comments, therefore, we ask that you complete this form carefully. Your prompt attention in completing this form (within 7 days) is important. Feel free to add comments on a separate sheet of paper. Thank you for your assistance. TO THE PASTOR The above named applicant is asking you to furnish a reference. The Student Mobilization Centre is a centre of the University of the Nations, a mission-oriented university under the auspices of Youth With A Mission, an international, multi-denominational Christian missionary organization. Thank you for your time and consideration. Please rate, according to what you have observed, the applicant s effectiveness in the following areas: Initiative: Social adaptability: Concern for others: Ability to follow: Leadership: Judgement/ Decision-making: Emotional stability: Health: Personal Appearance: Please rate (check off), according to what you have observed, the applicant s effectiveness in the following areas: Mental Ability: Industry: Reliability: Cooperativeness: Quick to comprehend Average Slow Hard worker Average Lacks persistence Meets obligations Average Neglects obligations Works well with others Average Avoids group activity Flexibility: Open to change Average Unyielding Christian character: Christian experience? Punctuality: Financial Responsibility: Well balanced Average Unstable Over-emotional Superficial Genuine and Growing Punctual Average Often Late Honors obligations Average Neglectful You may photocopy this page.

page 2 PASTOR CONFIDENTIAL REFERENCE FORM Does the applicant demonstrate the Lordship of Christ in his/her life-style? In what ways has the applicant served the local church? Would you recommend having this person on your church staff? Has the applicant ever been a source of disunity or dissension in the church? (if yes, please explain) Does he/she display high moral standards? Yes No Comment: Please comment on the applicant s family background (if known): On a scale of one to ten (ten being very dedicated) how would you rate the applicant's dedication to Christian service? Please explain: Is he/she prejudiced against groups, races, or nationalities? Comment: In your opinion, what are the applicant s reasons for applying to the U of N? What could the U of N SMC do to aid in the applicant s personal development? Overall, what do you consider to be the applicant s strong points, including special abilities: Does the applicant have a good self-image? Describe briefly Please add any other relevant remarks (i.e., medical, psychological, drugs, alcohol, sexual issues, or other areas of their life) we should know more about, to be of service to them: Would you recommend the applicant for acceptance into the University of the Nations/ YWAM? I recommend I do not recommend (Please explain) I recommend with this reservation Comments? Would your church consider supporting the applicant financially? Yes No Comment: I have known for years and believe that he/ she possesses the qualities indicated above. SIGNATURE Signed: Date: Name (please print): Position: Address: City: State/Province: Country: Postal/Zip Code: Phone: Email: Thank you!

YWAM Converge STAFF APPLICATION YWAM LEADER CONFIDENTIAL REFERENCE FORM TO THE APPLICANT Fill in the above and give to your YWAM or UofN School Leader. You should provide a stamped addressed envelope for the person filing this reference. Address envelope to: Student Mobilization Centre, P.O. Box 1526, Ocean City, NJ 08226 USA -or- Email to: admin@ywamconverge.org First: Last/Family Name: Middle: Current Address: City: State/Province: Postal/Zip Code: Country: Phone Number: Email: I, the above named applicant, WAIVE any right to have or obtain copies of this recommendation. Applicant s Signature: Date: The above applicant has applied for admission to work at UofN Student Mobilization Centre of Youth With A Mission, Inc. Serious consideration will be given to your comments, therefore, we ask that you complete this form carefully. Your prompt attention in completing this form (within 7 days) is important. This information will be treated as confidential. Please fee free to write additional comments on a separate sheet of paper. Thank you for your assistance. You should provide a stamped addressed envelope for the person filing this reference. Address envelope to: YWAM Converge/SMC, P.O. Box 1526, Ocean City, NJ 08226 USA TO THE YWAM LEADER REFERENCE: The above named applicant is asking you to furnish a reference. Thank you for your time and consideration. Please rate, according to what you have observed, the applicant s effectiveness in the following areas: Initiative: Social adaptability: Concern for others: Ability to follow: Leadership: Judgement/ Decision-making: Emotional stability: Health: Personal Appearance: Please rate (check off), according to what you have observed, the applicant s effectiveness in the following areas: Mental Ability: Industry: Reliability: Cooperativeness: Quick to comprehend Average Slow Hard worker Average Lacks persistence Meets obligations Average Neglects obligations Works well with others Average Avoids group activity Flexibility: Open to change Average Unyielding Christian character: Christian experience? Punctuality: Financial Responsibility: Well balanced Average Unstable Over-emotional Superficial Genuine and Growing Punctual Average Often Late Honors obligations Average Neglectful Does the applicant demonstrate the Lordship of Christ in his/her life-style? You may photocopy this page.

page 2 YWAM LEADER CONFIDENTIAL REFERENCE FORM In what ways has the applicant served the YWAM base ministries? Has the applicant ever been a source of disunity or dissension at your location? (if yes, please explain) Does he/she display high moral standards? Yes No Comment: Please comment on the applicant s family background (if known): On a scale of one to ten (ten being very dedicated) how would you rate the applicant's dedication to YWAM? Please explain: Is he/she effective with cross-cultural communication and ministry? Comment: In your opinion, what are the applicant s reasons for applying to serve as a staff member of the YWAM Converge/SMC? What could the SMC do to aid in the applicant s personal development? Overall, what do you consider to be the applicant s strong points, including special abilities: Does the applicant have a good self-image? Describe briefly Please add any other relevant remarks (i.e., medical, psychological, drugs, alcohol, sexual issues, or other areas of their life) we should know more about, to be of service to them: Would you recommend the applicant for acceptance as Staff with Youth With A Mission/Student Mobilization Centre? I recommend I do not recommend (Please explain) I recommend with this reservation Comments? I have known for years and believe that he/ she possesses the qualities indicated above. SIGNATURE Signed: Date: Name (please print): Position: Address: City: State/Province: Country: Postal/Zip Code: Phone: Email: Thank you!

YWAM Converge STAFF APPLICATION CONFIDENTIAL HEALTH INFORMATION FORM TO THE APPLICANT: This information is treated as confidential. Last/Family Name: First: Middle Name: Current Address: City: State/Province: Country: Postal/Zip Code: Male Female Date of Birth: (mm/dd/year) Age: Please rate your health: (circle one) Excellent Good Fair Poor If you have any significant physical impairment, please explain: Explain treatments or medications you are presently receiving or any you have received for a significant physical or emotional problem: Any special dietary restrictions? (NOT PREFERENCES) If yes, which Are you allergic to any medicines? If yes, which Do you have medical insurance that will cover you overseas? Yes No Name of Insurer Policy # Name of next of Kin Relationship Address Phone Med. Insurance coverage (briefly): PERSONAL HISTORY Please answer all questions and take to your physician. The omission of health history problems or incomplete explanation of the same can lead to removal of acceptance status. Your response to the questions will not necessarily determine admission considerations. Please check items below and comment on history problems checked on a separate sheet of paper. Have you ever had, or do you now have, any of the following: Back Problems Low Blood pressure Epilepsy Skin Condition Kidney Disease Insomnia Eye Trouble Shortness of Breath Diabetes Broken Bones Venereal Disease Hay fever Ear Trouble Surgeries Anemia Dislocation of joints High Blood Pressure Mental/Nervous Disorders Ulcer Heart Trouble Recurrent Headaches Stomach/Duodenal Head Injury Hepatitis Tumor/Cancer Paralysis Fainting Spells Rheumatism/Arthritis Asthma Scarlet Fever Jaundice Gall Bladder Problems Weakness Recurrent Diarrhea Intestinal Troubles You may photocopy this page.

page 2 ALLERGIES: CONFIDENTIAL HEALTH INFORMATION FORM Allergy: Food (specify) Allergy: Bee Stings Allergy: Penicillin Allergy: Serum Allergy: Sulfonamides COMMUNICABLE DISEASES: Chicken Pox Measles (Rubella) Measles (Rubeola) Mumps Pertussis OTHER (specify) FEMALES ONLY: Severe Cramps Please explain any other illnesses, conditions, or surgeries you have had or are going through currently: Are you presently under a doctor s care for any condition? Yes No Specify: No Yes Are you presently taking any medication? Are you allergic to any drugs? Yes No Specify: Yes No Specify: Do you have a history of emotional instability or psychiatric treatment? Yes No For how long: If Yes, when: Still in treatment? Please explain: Currently? No Yes Please explain: Do you have any history with: Eating disorders: Yes No Drug or alcohol abuse: Yes No Sexual issues: Yes No If Yes to any above, when: For how long: Currently? Yes No Please explain: Do you have any physical impairments, handicaps, or health conditions which require special attention? No Yes Specify: Have you been diagnosed as having HIV/AIDS? Yes No As certain medical conditions may preclude acceptance, this form must be completed by your physician or physician s assistant, and only if we do not have one on file (for example, if you were a student here we may have one on file, or if you have one at another YWAM base it can be transferred to us.) Physician s Name: (print) Date: Address: Phone:

page 3 CONFIDENTIAL HEALTH INFORMATION FORM MEMORANDUM OF AGREEMENT Youth With a Mission (YWAM) is an international religious order. It was organized as a corporation under the laws of the state of California for the purpose of carrying out the great commission of Jesus Christ found in Mark 16:15, Matthew 25:35-40, and Matthew 28:16-20. It invites qualified people who are dedicated to that purpose to become members of the order (volunteer members). It is expected, therefore, that individuals who are called to become volunteer members freely and voluntarily contribute and dedicate their labors. Their talents, and their lives to YWAM s effort to carry out the great commission, subordinating all worldly and personal ambitions to a total commitment for fulfill the great commission. With that calling and dedication in mind, it is understood the individual whose name appears below, hereby applies to become a volunteer member of YWAM, making an initial minimum two-year commitment. The applicant agrees the relationship of YWAM and the volunteer member shall be that of co-workers for God. The volunteer member understands, however, there is a pattern of discipline and structure of authority within the community of YWAM which he/she hereby agrees to submit to. Youth With a Mission is an organizational movement of Christians from many denominations dedicated to presenting the Gospel of Jesus Christ personally to this generation, to mobilize as many as possible to help in this task,and to the training and equipping of believers for their part in fulfilling the great commission. As Christians of God s Kingdom, we are called to love, worship, and obey our Lord, to love and serve his body, the Church, and to present the whole Gospel for the whole man throughout the whole world. We of Youth with a Mission believe that the Bible is God s inspired and authoritative word, revealing that Jesus Christ is God s Son, that man Is created in God s image; that he created us to have eternal life through Jesus Christ; that although all men have sinned and come short of God s glory, God has made salvation possible through the death on the cross and resurrection of Jesus Christ; that repentance, faith, love and obedience are fitting responses to God s initiative of grace towards us; that God desires all men to be saved and to come to the knowledge of the truth; and that the Holy Spirit s power is demonstrated in and through us for the accomplishing of Christ s last commandment, go ye into all the world and preach the gospel to every creature (Mark 16:15). It is understood that the volunteer member must secure contributions sufficient to cover his/her own ministry expenses and personal support from churches, associations of churches, from other organizations or persons, or provide support from his/her own resources. The volunteer member is entitled to us whatever facilities of YWAM may be available at the locations of member s particular place of work, but YWAM does not undertake to provide any special facilities. YWAM sponsors training centers for Christian discipleship which are operated by members of the order and which all prospective members must successfully attend at their own expenses before becoming a volunteer member. The volunteer member shall have no authority to enter into any contract or obligation on behalf of YWAM. This agreement between and the applicant has been entered into after prayerful consideration on the part of both parties. There are no promises made by either party to the other regarding anything not mentioned in this memorandum of agreement. I have read this memorandum and agree with its terms. I first entered into this memorandum of agreement when I joined YWAM International on or about at the YWAM center (base) located in (city/state). I am applying to become a volunteer member of Youth With M Mission - UofN Student Mobilization Centre - aka YWAM Converge. Please print full name: Signature: Current date: