National Youth Service

An Agency of the Ministry of Education, Youth and Information

6 Collins Green Avenue, Kingston 5
Website: www.nysjamaica.org Email: thenationalyouthservice@gmail.com
Tel: (876) 754 9816-8 Facsimile: (876) 754 9820

SUMMER PROGRAMME APPLICATION FORM

ALL SECTIONS MUST BE COMPLETED IN FULL USING BLUE OR BLACK INK
INCOMPLETE APPLICATION FORM WILL NOT BE PROCESSED

REQUIREMENTS: Completed Application form Copy of School ID

Between ages 17-24 with photograph attached Copy of National Issued ID
Persons with disAbilities Resume Copy of Birth Certificate
between ages 17-34 Copy of TRN Proof of Qualification (if any)

PERSONAL INFORMATION

1. Name:
Last Name First Name Middle Name

2a. Date of Birth: (dd/mm/yy): / / 2b. Current Age: __________ 2c. Sex:Male Female
3. Permanent Address:
Street Name & Number

Community/District Parish

4. Contact Information: - - -
Home Phone Mobile 1 Mobile 2

Email Address

5a. ID Type: School ID Passport Drivers License National ID 5b. ID #:

6. TRN: (Mandatory)

7. Are you a young person with a disAbility?* Yes No

If yes, please tick all that apply:
Physical disAbility Intellectual disAbility Other: ______________________________________
Visually impaired Deaf
*Indication of disAbility will not result in you being discriminated against but will support your placement.

BANKING INFORMATION
9. Do you have a Commercial Bank Account? Yes No 9a. Please state name of bank:

10. Account #: 10a. Branch #:

ACADEMIC PROFILE
11. Please indicate your current level of education: Secondary Tertiary Vocational Training
Other: _________________________________________________________

12. How many CSEC Subjects did you pass? Less than 3 subjects 3 or more subjects
13. Are you currently in school/ training: No, I am not in school Yes, I am in High School Yes, I am in University
14. Are you a High School Graduate? Yes No If yes, state year: _______________________

EMERGENCY CONTACT
15. In the event of an emergency please notify:
Emergency Contact 1:
Name:
Last Name First Name

Relationship: Contact Number(s): - / -

Emergency Contact 2:
Name:
Last Name First Name

Relationship: Contact Number(s): - / -

NOT FOR SALE NYS-F-SP-2017
 MEDICAL HISTORY

16. Do you have any medical conditions or allergies? Yes No

If yes, please state: ______________________________________________________________________________________

PERSONAL INTEREST AND SKILLS

17. Please select preferred placement phase (All tertiary students will be placed in July phase) July August
18. Please state preferred placement site*: ______________________________________________________________________
*Suggestion of placement site is not guaranteed but will help support your placement.
19. Please state your career interest: ___________________________________________________________________________

20. Are you computer literate? Yes No

21. Do you have any vocational skills (eg. mechanics, carpentry, housekeeping, masonry, cosmetology, etc.) Yes No
If yes, please state your skill(s):
_______________________________________________________________________________________________________

22. Please state any major volunteer activity you have participated in: _______________________________________________

_______________________________________________________________________________________________________

23. What do you expect to gain from the programme? ____________________________________________________________

_______________________________________________________________________________________________________

GENERAL INFORMATION
24. How did you learn about the NYS Summer Programme? (Tick all that apply)

School Radio Internet/ NYS Website Newspaper Family/Friend Social Media NYS Representative
Other: ____________________________________________________________________________________________________

25. Have you ever participated in the NYS Summer Programme? Yes No
__________________________________________________________________________ ____________________
Name of most recent organization Year of placement

DECLARATION
I, the undersigned, declare that the above information given in this application is correct to the best of my knowledge. I am
aware that any false or misleading information will result in my application being automatically rejected.

I further declare that I have attached all the required supporting documents and acknowledge that failure to submit same
with a fully completed application form will result in my application being delayed or rejected.

By completing this form, I have granted the National Youth Service permission to use any images captured for marketing
purposes.

Signature of Applicant Date of Declaration

NYS reserves the right to assign participants in July or August based on available placements.
THANK YOU FOR YOUR APPLICATION. WE LOOK FORWARD TO WORKING WITH YOU THIS SUMMER!
FOR OFFICIAL USE ONLY
Date Received: ____________________________

Age requirement met Resume School ID (copy)

Birth Certificate (copy) TRN (copy) Proof of Qualification (copy)
One passport size photo National Issued ID (copy) Bank Verification Form
Application Status: Complete Incomplete Participant Status: Eligible Ineligible

Data Entry: Complete Incomplete Placement Code:

Comments: _______________________________________________________________________________________________
_______________________________________________________________________________________________

Verified By: _________________________________ Date: ___________________________________

NOT FOR SALE NYS-F-SP-2017

 Instructions to complete resume

In completing your resume, please be guided by the following instructions:

Your Contact Information should include your full name, your address, your
telephone number(s) and your email address.

Your Objective is a statement of what your goals are and what benefit you will
be able to add to the workplace.

In the Education History section, you are required to list the names of the
school/institution(s) you have attended and the qualification you have attained
(example: The Queen High School (CXC)). Always ensure that you begin with
the most recent information first. If you are a student attending a tertiary
institution, you can specify the area of study and indicate that it is pending.

In the Employment History section you should include the name of the two most
recent companies, positions held, the duration and duties performed; again,
you should begin with the most recent information first.

Your References should be individuals (excluding family members) who can

verify the information you have written and recommend you as a suitable
candidate for this programme. The contact information for your references
should include full name, address and telephone number.
 RESUME

Contact Information

Objective

Education History
Years Qualification Achieved Date
Name of School (s) (e.g.: # of CXCs, # of CAPE,
Attended Certificate, Diploma, Degree) Awarded
 Employment History
Name of Company 1: Name of Company 2:

Duration: Duration:

Position Held: Position Held:

Key Responsibilities: (Skills used to carry out the job) Key Responsibilities: (Skills used to carry out the job)

Name of Company 3: Name of Company 4:

Duration: Duration:

Position Held: Position Held:

Key Responsibilities: (Skills used to carry out the job) Key Responsibilities: (Skills used to carry out the job)

References

1. .... 2. ....

.... ....

.... ....

.... ....