CARIBBEAN AND NORTH AMERICA COUNCIL FOR MISSION

(CANACOM)

YOUNG ADULTS IN MISSION

WORKCAMP 2003

in

CURACAO

JULY 12 – AUGUST 2, 2003

PARTICIPANTS’ REGISTRATION FORM

Participants are asked to obtain a registration form from their denomination AFTER BEING CHOSEN TO ATTEND THE WORK CAMP. The participant’s minister and an executive officer of the national church should countersign it.

(Those chosen will return their application to CANACOM by March 31, 2003.)

Caribbean and North America Council for Mission

31 Mannings Hill Road, Kingston 8. JAMAICA W.I.

Tel/fax(876) 969-6410 Email: [email protected]

 

SURNAME:…………………………………………………………male/female(circle one)

FIRST NAMES. …………………………………………………single/married(circle one)

NAME YOU PREFER TO USE…………………………………………………………

MAILING ADDRESS………………………………………………………………………..

…………………………………………………….…………………………………

TELEPHONE(Work)……………….……………Home……….………………………………

EMAIL ADDRESS:…………………………………………………………………………

DATE OF BIRTH ………………………………………………………………………….

PRESENT OCCUPATION …………………………………………………………………

1.Mother Tongue

Do you have a working use of English?

2. Church Life

a. Of which congregation are you a member?……………………………

b. What responsibilities have you held in the Church?

 

c. Have you taken part in ecumenical, regional and/or international activities before?

 

d. Now that you have been selected by your Church to attend YAM2003 workcamp,

indicate how you plan to use the Workcamp experience on returning home?

 

 

 

3. Interests and Expectations

a. What are some of your interests and hobbies? Any abilities in art?

E.g. Music and drama?

 

b. What do you expect to gain from the workcamp?

 

c. What do you hope to contribute?

 

4. Health

a. Is your health generally good?

b. Do you have a medical condition (e.g. allergy, asthma, any disability) that

the planning team should know about?

c. Any special dietary needs?

5. Visa and Passport details and enclosures

a. Will you need a visa to enter Curacao?

b. Passport number: Place and date of issue

c. Expiry date: Nationality.

(It is important that you enclose photocopies of the pages in the passport, which

show your photograph, passport number and expiry date)

 

Signed……………………………………………………...Date………………...

Please attach a recent photograph of yourself:

 

6. Endorsement from the local and national church

As the participant’s local congregation we hope to share in, and benefit from the

participants’ workcamp experiences in the following ways:

 

 

 

Name & address of Pasto/r//Minister

 

Signature of Minister……………………………...Date………………...

Name & address of national officer

Signature of

National Church Officer …………………….. Date ……………….

(Designation)/Nature of Responsibility……………………………………

A/YAM 2003/YAM Workcamp 2003 Registration Form

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