Staff Application

General Staff Application for UofN Battambang
1. All parts of this application must be completed in detail. All portions (including reference forms) must be received in our Battambang office before we can consider you for service with UofN Battambang.

2. Registration fee of US$ 20.00 can be paid upon arrival.

3. A recent photo, references, and medical forms must be emailed to uofnbattambang@yahoo.com.
General Information
Full Name*

First NameMiddle NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail*
Birth Date*

DayMonthYear
Place of Birth*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Gender*
Nationality*
Citizenship*
Passport No.*
Place of Issue*
Date of Issue*

DayMonthYear
Date of Expiration*

DayMonthYear
Marital Status*
Date Status Changed (unless single)

DayMonthYear
Accompanying Children
Full Name

First NameLast Name
Date of Birth

DayMonthYear
Place of Birth

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Add another child?

YesNo
Full Name

First NameLast Name
Date of Birth

DayMonthYear
Place of Birth

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Add another child?

YesNo
Full Name

First NameLast Name
Date of Birth

DayMonthYear
Place of Birth

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Education/Experience
List your skills and/or hobbies (please be specific, ie. teaching, IT, music, construction, etc.)*
High School
Name*
Graduation Date*

DayMonthYear
University/Trade School
Name
Graduation Date

DayMonthYear
Academic Field
Degree/Certification
YWAM Schools Completed
School Name
Graduation Date

DayMonthYear
Location
Director's Name

First NameLast Name
Add another YWAM School?

YesNo
School Name
Graduation Date

DayMonthYear
Location
Director's Name

First NameLast Name
Add another YWAM School?

YesNo
School Name
Graduation Date

DayMonthYear
Location
Director's Name

First NameLast Name
Ministry
Position
Location
Director's Name

First NameLast Name
Starting Date

DayMonthYear
Ending Date

DayMonthYear
Add another position?

YesNo
Position
Location
Director's Name

First NameLast Name
Starting Date

DayMonthYear
Ending Date

DayMonthYear
Employment (most recent)
Position
Employer
Starting Date

DayMonthYear
Ending Date

DayMonthYear
Add another position?

YesNo
Position
Employer
Starting Date

DayMonthYear
Ending Date

DayMonthYear

Personal
Do you have a prayer and financial support base that will enable you to fulfill your intended commitment to UofN Battambang? Please explain*
Does your family understand your desire to work in Cambodia? Do they support you?*
Is there any domestic situation or personal matter, which might necessitate your returning from the field? If yes, please explain*
Please describe your Christian experience*

Ministry
What expectations do you have for your work in Cambodia?*
What ministry gift would you be most fulfilled in? (i.e. evangelism, pastoral, administration, teaching)*
Please write (clearly) the leading of God you have received to work in Cambodia*

Certification
I certify that all the information in this application is complete and accurate.
Signature

Clear
Date

MonthDayYear
Parent or Guardian's Signature (if you are under 18 years old)

Clear
Date

MonthDayYear
Relationship
Submit Application
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General Staff Application for UofN Battambang