MAP Application Form

MAP Application Form
Please be aware that all information pertaining to your application may be made available to the relevant Elim Missions Staff and missionaries or Elim Global partners directly involved in any overseas placements you undertake. No information provided on this application will be given to any persons or organisations beyond this.

Data Protection Act 1988: The applicant should be aware the ELIM FOURSQUARE GOSPEL ALLIANCE will retain on record what is classified by the Data Protection Act 1998 as sensitive personal data as well as personal data. This requires the express consent of the Applicant and completing and submitting this Application you will be deemed to be giving consent to the retaining of such data and acknowledging that the process is necessary in performing or exercising a right or obligation in connection with the Applicant's appointment.

Introduction

We are so excited that you interested in taking part in the Missionary Apprentice Programme with Elim Missions.

To be considered for MAP we ask that you complete the following application form that will request your details, emergency contact info and also individuals we can obtain references from – we ask that you complete the application completely and honestly.

Once we receive your application we will seek references from those names submitted. You will then hear from us as the whether your application has been successful.

Please note: As part of the applicatin process you will be required to send us a copy of the photo page of your passport as well as a copy of a DBS check if you have one already through the Elim Pentecostal Church. Photos or Photocopies of these documents will be sufficient as long as they are legible. Once you submit your application you'll recieve an email with further information about this.

Applicant's Details
Name (As it appears on your passport)*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityCounty

PostcodeCountry
Primary Phone Number*
Alternative Phone Number
E-mail*
Please ensure this is correct. On completing this form confirmation will be sent here.
Date of Birth*

DayMonthYear
Nationality (As it appears on Passport)*
Passport Number*
Skype Name (If you have one)

References

We require 2 references. One must be completed by your Pastor/Church Leader. We request all references to be sent in English.
Church Name*
Address*

Street Address

Street Address Line 2

CityCounty

PostcodeCountry
Reference 1
Pastor/Church Leaders Name*

First NameLast Name
E-mail*
Address*

Street Address

Street Address Line 2

CityCounty

PostcodeCountry
Reference 2
Name*

First NameLast Name
E-mail*
Address*

Street Address

Street Address Line 2

CityCounty

PostcodeCountry
How do you know this person?*

Education and Employment
Please give details of subjects taken at GCSE or equivalent
Please give details of subjects taken at A-Level or equivalent
Please give details of further education, professional or public qualifications attained
Current Occupation (please state if unemployed and give details of previous employment below)*
Employers Name
Employed since

DayMonthYear
Please give details of previous employment:

Emergency Contact Information

Please provide Emergency Contact information. Should you be accepted this person will be contacted in the case of emergency during overseas placements.
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityCounty

PostcodeCountry
E-mail
Primary Phone Number*
Alternative Phone Number
How do you know this person?*

Medical Information

All information provided is in confidence and will be shared only with those dealing with your application and with Missionaries and/or partners facilitating the course.
Doctors Name*

First NameLast Name
Surgery Address*

Street Address

Street Address Line 2

CityCounty

PostcodeCountry
Surgery Phone Number
Give details of any medical conditions, disabilities and allergies (food/medication).
Give details of any current medication
If you have travel insurance, please provide the Company Name and Policy Number:
Date of last Tetanus:

DayMonthYear

Final Steps
Have you had a Criminal Records Check (DBS) in the last 3 years through the Elim Pentecostal Church?

YesNo
That's all the questions in this application. However, there are a few additional things you'll need to do after you hit 'Submit':

1. Send us a copy of your Passport

2. Send us a copy of your Elim DBS Certificate

If you don't have a DBS with Elim we will send you information on how to get one.

3. Complete and send us a Self Declaration Form

For each individual seeking to be a part of MAP, Elim Missions requires a completed Self Declaration form stating that they have not been barred from working with children.

Full information about these 3 requirements and where to send them will be in your application confirmation email.
Should be Empty:

MAP Application Form

Applicant's Details

References

Reference 1

Reference 2

Ministry Details

Education and Employment

Emergency Contact Information

Medical Information

Final Steps