Eastgate Gap Year Application Church / Church Life / Youth at Eastgate / Eastgate Gap Year / Eastgate Gap Year Application Step 1 of 4 25% Name* First Last Date of Birth* Gender*MaleFemaleAddress* Street Address Address Line 2 City County / State / Region Postcode / ZIP Country CountryAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSaint MartinSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe 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 ministryYouthMedia What 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.