Alliance Youth Works

Contact:
John Phillips

Address:
AYW Grow
Unit 10, West Bann
Development
8 Killowen Court
Coleraine
BT51 3TP

Tel: 028 703 20814

Email:
johnphillips@alliance
youthworks.org.uk

Contact:
Alice McAlary

Address:
AYW Grow
Unit 10, West Bann
Development
8 Killowen Court
Coleraine
BT51 3TP

Tel: 028 703 20814

Email:
alicemcalary@alliance
youthworks.org.uk

Instructions

To register as a leader for a Grow Team:
> Everyone must fill out the form below. Asterisk (*) denotes required field.

> Once you submit the form you will be redirected to the Paypal pages where everyone should complete payment.

> In addition under 18s must download a parental consent form and return it to: AYW Grow
Unit 10, West Bann Development
8 Killowen Court
Coleraine
BT51 3TP This form will be available on the confirmation page when you have completed payment, or on the Forms page (under the "Going on a Team" menu above).
Note: You are not considered registered for Grow Teams until you have submitted a form and completed payment.
Your form will not be available if you submit it then leave the website without completing payment - if you still wish to register in this case you would have to fill in the entire form again.
If you have any problems with the process, please do not hesitate to get in touch immediately using the details on the right.

Grow Teams Leader Registration

Details

* Full name

* Age

* Marital status

* Date of birth

* Permanent address

* Postcode

* Telephone #

Mobile #

* Email Address

Term-time address (if appropriate)

Term-time postcode

Education and Employment

If you are still in education, at what level of school/college?

What subjects are you studying?

Are you or have you been employed? Please give dates, company, job title and main duties.
(include part-time/weekend employment, starting with the most recent)

Interests

* What do you do in your spare time? What are your hobbies and interests? Do you do any voluntary work?

Medical and Social

* How would you describe your general health?

* Have you any allergies?

Yes No

If yes, give details

* Are you diabetic?

Yes No

* Have you had any serious illnesses in the last three years?

Yes No

If yes, give details

* Do you intend to take prescribed medication while working with children or young people?

Yes No

If yes, give details

* Have you suffered from any depressive illness in the last five years?

Yes No

If yes, give details

* Do you have any psychological or physical conditions that you think we should know about?

Yes No

If yes, give details

* Are you vegetarian?

Yes No

* Do you have any special dietary requirements?

Yes No

If yes, give details

Declaration of offence

* Do you have any prosecutions or have you ever been convicted at a court or cautioned by the police for any offence?

Yes No

If yes, please provide details of all pending prosecutions, convictions, cautions or bind over orders. You should include, if possible, the offence, the approximate date of the court hearing and the court which dealt with the matter.

(You are advised that under the provisions of the Rehabilitation of Offenders (Exceptions) Order (NI) 1979, as ammended by the Rehabilitations of Offenders (Exceptions)(Amendment) Order (NI) 1987, you should declare all convictions, including 'spent' convictions)

References

References should not be requested from relatives.

Friend

* Name

* Telephone #

Clergy

* Name

* Telephone #

Professional i.e. work/education

* Name

* Telephone #

Church Involvement

Name of church

Denomination

Term-time

* Describe briefly the beinning and growth of your faith in Jesus Christ

* How do you live out your Christian faith in your present situation?

* How would you advise someone seeking to become a Christian?

Declaration

> I declare that all the above information is correct and true.
> I agree to inform AYW if any of the above information changes after I have sent this form (e.g. health, criminal convictions).
> I am in good health and believe I am able to carry out the tasks required of me.
> I agree to respect the authority of the AYW leadership and any guidelines set down by them.
> I will make myself available for the set training events, as far as is possible for me to do so.

* Please tick

Team Selection

Please use the table below to select which teams you wish to do this summer. Please note:
> Each team costs £37, plus £8 for your Grow Team T-Shirt (you only need one T-Shirt!)

> You should only select a team if you can commit to the entire duration of the team

> With this in mind, please do not sign up to two teams that happen at the same time!

> We do not advise you do two teams in a row - Grow Teams are very tiring!

> If you are not sure where you want to go, click the "Put me anywhere" box

Date	Location		Cost
7th - 13th July	Brannockstown
14th - 20th July	Maghaberry
21st - 27th July	Bangor
28th - 3rd August	Burnside (Portstewart)
28th - 3rd August	Florencecourt
11th - 17th August	Kilkeel
18th - 24th August	Knocknamuckley
Put me anywhere!	Feel free to leave a note below!
T-Shirt	Select size:		£8.00
		Total:	£8.00

Selected "Put me anywhere" and want to give us an idea of when you are free, or have any notes to give regarding your application in general?

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Website created and maintained by Craig McCarter < thecraigery@googlemail.com>