YOS Application Form 2013

7/28/2019 YOS Application Form 2013

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Year of Service Volunteer Program (YOS)

Xavier University

Volunteer Application Form

A. PERSONAL PROFILEName ______________________________________________ Nickname ______________

Last First Middle

Sex ____________ Status ______________ Height __________ W eight _____________

Age _____________ Birthday __________________ Birthplace ________________________

Citizenship _______________________________ Religion _____________________________

Home Address __________________________________________________________________

City Address ____________________________________________________________________

Cellphone No. __________________________ Email: _____________________________Guardian ______________________________ Tel. No. ____________________________

B. FAMILY BACKGROUNDFather __________________________Age _______ Occupation ______________________

Mother __________________________Age _______ Occupation ______________________

Brothers and sisters from eldest to youngest:

Name Age Civil Status__________________________ ____________ _____________________________________________________ ____________ ___________________________

__________________________ ____________ _____________________________________________________ ____________ ___________________________

Your position in the family _________________________________

C. EDUCATIONAL BACKGROUNDSchool/Place Year Graduated Honors/Awards

Elem

_________. ______________________________ _____________ _________________

H.S.

_________. ______________________________ _____________ _________________

College

_________. ______________________________ _____________ _________________

Course/Degree

_____________________________________________________________________________

Other Colleges

_________. ______________________________ _____________ _________________

2x2


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D. SCHOOL INVOLVEMENTSCollege organizations to which you belonged and/or major activities you have

participated in:

Org./Activities Position Year

_________________________________ _______________________ _____________

_________________________________ _______________________ ______________________________________________ _______________________ _____________

Seminars and trainings you have attended :

Name Conducted by Year

__________________________ _______________________ _______________________________________ _______________________ _______________________________________ _______________________ _____________

E. WORK EXPERIENCEJob Description Employer Year

_____________________________ _______________________ __________________________________________ _______________________ __________________________________________ _______________________ _____________

F. TALENTS AND SKILLSWhat would you consider as your talents?

_______________________________________________________________________

Skills you feel confident enough doing and those you think you possess

_______________________________________________________________________

Languages and dialects spoken:

Fluently ____________________ ___________________ ____________________

Fairly ______________________ ___________________ ____________________

G. MEDICAL HISTORYPrevious/present illness ___________________________________________________

Any health problems that might require medication? __________________________


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H. WORK PREFERENCE (rank at least 3)( ) Community Organizing ( ) Tribal Organizing

( ) Education and Training ( ) Literacy Program

( ) Administrative Work ( ) Project Management

( ) Rural Finance Management ( ) Cooperative Building

( ) Assisting Parish Work ( ) Research and Documentation( ) Farm Technical Assistance ( ) Issue Advocacy/Coalition Building

( ) Health and Nutrition ( ) Livelihood/IGPs

Others, please specify _____________________________

Are you willing to be assigned anywhere as may be designated by the YOS?

_________ Yes __________ No

If no, why? _________________________________________________________

I. REFERENCES( Please give 4 names of people whom know you well and are in the position to judge

your general character and motivation. At least one should be able to judge your

academic standing. Inform that you have chosen them as you references.

Name Designation Complete Address

________________________ ____________________ _________________________________________________ ____________________ _________________________________________________ ____________________ _________________________

Below is the checklist of requirements by the Program for the applicants.

Check the items that you have already completed. Thank you and good luck!

( ) 2x2 photo ( ) References

( ) Essay 1.

( ) Parents consent 2.

( ) Medical Certificate 3.

( ) Transcri t of Record 4.

Name and Signature of Applicant ___________________________________________


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GUIDE QUESTIONS FOR ESSAY:Please answer each question.1. How do you describe yourself?2. After attending the YOS Orientation and activities, how do you describe the

program? What about it that you find significant?

3. Give a brief description of your understanding of social development.4. How do you see yourself five (5) years from now?5. What is your greatest fear and hope in life?6. What three (3) things at this stage in your life do you consider very important to

you and why?

7. How will YOS help you with your plans and ambitions?8. What are the three (3) traits you feel good about yourself?9. What are the three (3) things you would like to change about yourself?10. What are your other options after graduation aside from joining YOS?11. If accepted, what are your expectations from the program?12. How long would you like to work in this kind of career?13. As part of the application process, are you willing to join follow-up activities

in relation to deepening your orientation and interaction of the YOS program?

( ) Yes ( ) No


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Date: ______________

Dear ________________________,(Parents Name)

Your daughter/son ____________ has applied to join the YOS Volunteer Program Year 2013-2014

batch 20 of volunteer-trainees to work for social, peace and development in various places inMindanao. To prepare them, they shall be given a special formation and training during the summer

after their graduation. They shall be sent to our partner NGOs/POs, Dioceses/Parishes and Government

to assist in building cooperatives, giving agro-technical assistance, education and training, health careprograms, value formations and other social support services to the communities.

Just like many generous young people who have grown concerned for others, your child is willing to

commit herself/himself through this program as an active response to the call of service. We areindeed, in search for such dedicated men and women whose vision of their education is a continuing

responsibility to build, to help and serve especially the less fortunate sectors and communities.

Although, your childs desire to join the Year of Service Volunteer Program is a personal

response, we believe that your own support and blessing in his/her decision is equally important

in our consideration of his/her application to the program. Enclosed are documents to help you

know more about the programs thrust, mission and areas of work. You can also visit us at ouroffice at Volunteer Center for Peace and Development, Manresa Compound Xavier University,

Fr. W. F. Masterson, S.J., Ave., Carmen, Cagayan de Oro City, mobile number 09261904499.

We wish that beyond understanding your childs desire to be of service, you will appreciate the fact

that giving your YES support would mean an opportunity for wide exposure and enriching

experience for your child and at the same time can be your own contribution to the continuing peaceand development endeavors for Mindanao and the whole society.

Thank you very much. God bless you and your family!

Very respectfully yours,

Signed: Pernalyn T. Beja

Program Coordinator


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To the YEAR OF SERVICE PROGRAM (YOS) Xavier University

( ) I am aware of my childs desire to join YOS and I give him/her our blessing.

( ) I am aware of my childs application to YOS but I would like to know more

about the program before giving my consent.

Other comments: ________________________________________________________________________________________________________________

________________________________________________________

____________________________ __________________________________Applicants Name Parents Name and Signature

Date: _____________________________


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MEDICAL FORM

_______________________________________

Name of Applicant

TO THE EXAMINING PHYSICIAN. The purpose of this physical exam is to assure theYear of Service Volunteer Program that the above-named applicant is of good health

and does not have any impediments to working as YOS trainee.

The YOS is a university program that sends graduates of XU and other

universities/colleges to work as trainees in social development usually in rural areas

where life is much simpler and luxuries are absent. A YOS trainee therefore should

be physically and emotionally healthy for such an environment, with fewer problems

to adjust to a new situation.

1. Please indicate whether the applicant is in good health, having no majorailment or impediment.

2. If the applicant has any impediment/s, please give details.3. Does the applicant require medication?4. Are there allergies?5. Are there dietary restrictions?6. Are there climatic requirements?

Remarks:

Date: ______________ Physicians Printed Name: ________________________

Signature: _____________________________________

Address: ______________________________________

Documents

YOS Application Form 2013