( ) Shortlisted / ( ) Rejected / ( )
KIV
Remarks:
APPLICATION FOR YOUTH CORPS SINGAPORE
LEADERS PROGRAMME
Application Closing Date: 16 September 2016
How to Apply
1. Complete the application form below.
2. Submit the soft copy of the form (word format) via email to:
3. Receive our email acknowledging your submission and a subsequent email notification regarding the interview if you have been shortlisted within one month after the application closing date.
4. Should you have any questions, please email: or call 6734 4233.
Important Notes
1. Only Singapore Citizens / Permanent Residents aged 17-25 years old residing in Singapore may apply.
2. Selected applicants must be willing to commit to:
· Selection Exercise – 8 October 2016 or 22 October 2016
· CP World Café – 5 November 2016
· Residential Induction Programme from 7-11 December 2016 upon selection;
· Trainings either 7-8 January 2017 or 14-15 January 2017; and
· Local community project implementation from December 2016 to June 2017
SECTION 1 – PERSONAL PARTICULARS / Affix recent Passport size photograph or attach a softcopy hereSurname / Name as in NRIC/Passport/PR
Dr/ Mr / Mrs / Miss / Mdm / Chinese Characters
(if applicable)
Home Address / Home Tel No
Handphone No.
Name of School/ Employer / Office Tel No. / Medical Condition
(if any)
Designation/Occupation / Email / Highest Education Attained
Country of Birth / Nationality / NRIC/Passport/PR No.
Gender
Male / Female / Date of Birth / Dietary Restrictions / Medications currently being used
Race / Marital Status / T-Shirt Size
( ) XS ( ) S ( ) M
( ) L ( ) XL ( ) XXL
SECTION 2 – NATIONAL SERVICE [For Male Singapore Citizens Only]
Date of Enlistment/ Expected Date of Enlistment / Operational Ready Date (ORD)/ Expected ORD Date
SECTION 3 – INVOLVEMENT IN NOMINATING ORGANISATION [For Applicants nominated by an Organisation]
Name and Address of Nominating Organisation / Duration of Involvement
Positions Held (in chronological order)
Nominee's main Area(s) of Involvement in Nominating Organisation (not more than 30 words)
SECTION 4 – KNOWLEDGE OF LANGUAGES AND DIALECTS
Written & Spoken / Written / Spoken
SECTION 5 – EDUCATIONAL BACKGROUND (in chronological order)
Schools/Institutions and Country / Highest Standard Passed / Year
Other Professional Qualifications
Type and Duration of Awards/Scholarships Held
SECTION 6 – BACKGROUND ACTIVITIES (in chronological order)
Details of Co-Curricular Activities and positions held for the last 24 months. / Period of Involvement
Details of membership with positions held in clubs, associations or societies, including grassroots involvement for the last 24 months. / Period of Involvement
Details of past volunteering experiences for the last 24 months (including Youth Expedition Projects (YEP). / Period of Involvement
Details of past involvements in NYC programme, if applicable (e.g. Young ChangeMakers (YCM), Ship for Southeast Asian and Japanese Youth Programme (SSEAYP)). / Period of Involvement
SECTION 7 – KNOWING YOU
1. Why do you want to join the Youth Corps Singapore Leaders Programme? What do you hope to gain/learn from participating in the programme? You may choose to tell us more using other formats (e.g. drawing, video, etc) as long as they do not exceed 50MB. If you choose to submit a medium other than in writing, please include a brief write-up on your thought processes behind the final product. Remember to include your attachment in your email submission. [Max 500 words]
2. How have your past volunteering experiences impacted you? Share with us your skills, resources and abilities that you think would help you in your Youth Corps Singapore journey and in growing the Youth Corps Singapore community. Please be as specific as possible. [Max 500 words]
3. What is your preferred area of focus under Youth Corps Singapore?
Focus Areas / Please select up to 3 focus areas in order of your preference
(1 = first choice) / Please share with us your reason(s) for selecting the focus area(s).
1. Education
2. Special Needs
3. Health
4. Environment
5. Arts, Sports and Heritage
6. Children and Family
7. Youths
8. Elderly
V
How did you come to learn about Youth Corps Singapore? You may indicate more than one option.
Print media (E.g. Newspapers, print advertisements, posters)
Social media (E.g. Facebook, Instagram)
Outreach events (E.g. Recruitment talks in schools)
Current/past Youth Corps Aspirant
Word-of-mouth (E.g. Family, friends, teachers, colleagues)
Outdoor media (E.g. bus-stop shelter advertisement, LED Screen advertisement)
Others (Please specify):______
SECTION 8 – IMPORTANT DATES
Shortlisted applicants will be invited to attend a selection exercise. Please indicate your availability and keep these dates free. Youth Corps Singapore will inform you of the selection date that you have been assigned to.
I am available on the following date:
( ) 8 October 2016, 9.00am to 6.00pm
( ) 22 October 2016, 9.00am to 6.00pm
If successful after the selection exercise, applicants will be required to take part in a mandatory residential Induction Programme. Please indicate your availability.
( ) Yes, I am able to attend the Induction Programme in full from 7-11 December 2016.
( ) No, I am unable to attend the Induction Programme. I would like to be considered for the next intake.
SECTION 9 – EMERGENCY CONTACT
Name / Relationship / Contact Number
SECTION 10 – MISCELLANEOUS
1. Have you suffered, or are suffering from any medical condition, illness, disease, mental illness or physical impairment? / Yes / No
2a. Do you have a criminal record in Singapore? / Yes / No
2b. Have you ever been convicted of a criminal offence in a court of law in any other country? (excluding criminal records disclosed above) / Yes / No
3. Have you been charged with any criminal offence in a court of law in any country for which the outcome is pending? / Yes / No
4. Have you ever been declared a bankrupt? / Yes / No
If your answer is “Yes”, please give details in the space below and provide documentary evidence.
5. Do you have any intentions to further your studies overseas or relocate for work during your time with Youth Corps Singapore i.e. December 2016 to June 2017? / Yes / No
If your answer is “Yes”, please give details on the duration of absence from the programme.
SECTION 11 – AGREEMENT
(1) I give my consent for Youth Corps Singapore to obtain and verify information from or with any source as it deems appropriate for the assessment of my application.
(2) I understand that if selected, I am a representative of Youth Corps Singapore and agree to adhere to Youth Corps Singapore’s volunteer code of conduct which will be signed prior to the Induction Programme.
(3) I hereby give Youth Corps Singapore my permission to license the Content (e.g. photos, videos, quotes, interviews and other related media content) and to use the Content in any Media for any purpose (except pornographic or defamatory) which may include, among others, advertising, promotion, marketing and packaging for any product or service. I agree that the Content may be combined with other images, text, graphics, film, audio, audio-visual works; and may be cropped, altered or modified.
(4) I declare that the information in this application and any supporting attachments provided is to the best of my knowledge and I have not wilfully suppressed any material fact. I accept that if any of the information provided by me in this application is in any way false or incorrect, my application may be rejected or my membership will be ceased. I give my consent for the relevant Government authorities to obtain and verify information from or with any source, as you deem appropriate for the assessment of my volunteer work with Youth Corps Singapore.
(5) I understand that the approval of my application is subject to the consideration and final decision of the Youth Corps Singapore panel.
(6) I consent to receive the following (Please tick):
Communications on programmes and/or events in connection with Youth Corps Singapore and the National Youth Council (e.g. community service opportunities, skills development workshops and alumni benefits).
(Please include an e-signature or scan the signed document)
PARENTAL CONSENT (for applicants under 18 years old)
Parent / Guardian, please read, sign and date the following:
I hereby certify that the information given by the applicant is true and correct. I agree not to hold the Organisers liable for any injury, loss or damage that my child may suffer or sustain in the course of or in connection with his/her participation as a Youth Corps Singapore member, and to allow the Organisation to use the Content stated in Clause 3 for its purposes.
(Please include an e-signature or scan the signed document)
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