Recruitment National Registration Number National Insurance Number Last Name First Name Middle Initial(s) Address 1 Address 2 Date of Birth Country of Birth Sex Male Female Age Union Status Single Married Divorced Separated Widowed Common-Law Number of Children (if applicable) Parent/Guardian Address Telephone (home) Telephone (work) Parent/Guardian Address Telephone (home) Telephone (work) Educational History: Primary From To Secondary From To Other From To Qualifications: Subject Year Examining Body Level Grade Subject Year Examining Body Level Grade Subject Year Examining Body Level Grade Subject Year Examining Body Level Grade Subject Year Examining Body Level Grade Tell Us About Yourself: Are you a member of a Youth/Community Group/ Sports Club? Do you have any special interests/hobbies or skills? Are you presently employed? If 'Yes', please state whether full-time or part-time. What career would you like to pursue? State three alternative choices: Can you swim? My religion is: I have a disability which is: Please provide the following sizes: Shirt Pants Shoe Personal Statement: On this page, write a brief statement describing your background, your plans for the future and how the Barbados Youth Advance Corps can help you achieve your goals. Also include any other information that you feel may be relevant. Medical Questionnaire: Do you have or have you ever had Rheumatic Fever? Do you have or have you ever had Asthma? Do you have or have you ever had Allergies? Do you have or have you ever had Epilepsy? Do you have or have you ever had Diabetes? Do you have any mental or physical disorders not listed above? Are you allergic to any medications? What is your blood type? Do you follow a special diet? If so, please explain. This application package also includes two reference forms and the following should be submitted: A Certified copy of your Birth Certificate Certified copies of Qualifications A Police Certificate of Character A copy of your last School Report A Medical Certificate Two certified recent passport size photographs Upload Files Signature of Applicant ❌ Signature of Parent/Guardian ❌ Date Date Send
