Eastgate Gap Year Application Church / Church Life / Eastgate Gap Year / Eastgate Gap Year Application Step 1 of 4 25% Name* First Last Date of Birth* Date Format: DD slash MM slash YYYY Gender*MaleFemaleAddress* Street Address Address Line 2 City County / State / Region Postcode / ZIP Country CountryAfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Email* Phone*Next of Kin's Name* First Last Relationship to you*Phone* Save and Continue Later Eastgate GapHow did you hear about Eastgate GAP?*Why do you want to do Eastgate GAP?*Which stream would you like to apply for?*Please number each stream in terms of preference, 1 for most desired, 4 for least desired.WorshipChildren's ministryYouthMediaWhat experience do you have in your preferred area/s?*e.g. experience in photography/filming, editing, social media etc. If applying for the music stream, please list any instruments played and level of ability.Church backgroundPlease give a short testimony of how you became a Christian and what your journey has been like so far.*What's the name of your Church?*How long have you attended there?*Describe your involvement at your Church. What ministry activities have you served in?*5. Have you been baptised in the holy spirit?*NoYesCan you describe what happened?* Save and Continue Later Education historyPlease list your schools/university and qualifications obtained.*Any other relevant qualifications*Have you left full time education*NoYesWhat are you currently doing?*Personal informationDo you have any health issues, either physical or mental that we should be aware of?*YesNoPlease explain what they are and any ongoing medication or support needed*Health issues will not necessarily prevent you from doing this course, but it is important that we know so we can offer you the correct support. If relevant, please explain how your health issues will affect your day-to-day life and participation in the courseAre there any life dominating/addictive issues (e.g. drugs, alcohol, pornography) that you are currently struggling with that we should be aware of?*NoYesPlease explain*Have you ever been involved in the occult, witchcraft or cults?*NoYesPlease explain.* Save and Continue Later Personal interestsWhat do you enjoy doing in your spare time?*What would you say your biggest strengths are?*What would you say your biggest weaknesses are?*Describe one person who has influenced you in your life and how:*Do you have a sense of what to do in the future, and if so what?*Do you have an idea of what you'd like to do at the end of Eastgate GAP? i.e. University, employment, unsure?*Please give brief details of how you intend to finance your year at the school.*Acceptance on the course is dependant on a DBS criminal record check, which will be carried out before the course starts. The course fee needs to be paid in full by September 2018.CAPTCHA Save and Continue Later This iframe contains the logic required to handle Ajax powered Gravity Forms.