Youth Alive South Australia Academy Application Form

Please fill out the form below to apply for the Youth Alive Leadership Academy Internship Program

Name *

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Contact Number *

Email Address *

Date of Birth

YYYY

Blue Card Number and Expiry Date

If you do not currently have a Blue Card please note that in the box below and an application can be completed through the induction process.

Church Name You Attend *

Senior Pastor Name *

Senior Pastor Name

First Name

Last Name

Youth Pastor Name *

Youth Pastor Name

First Name

Last Name

Youth Pastor Contact Number *

FINANCE INFORMATION FOR DOMESTIC STUDENTS

THE YOUTH ALIVE LEADERSHIP ACADEMY INTERNSHIP PROGRAM HAS A FINANCE COMPONENT OF 2 PARTS. INITIALLY THERE IS A NON-REFUNDABLE $500 FEE PAYABLE UPON ACCEPTANCE INTO THE INTERNSHIP PROGRAM. THIS FEE IS PART 1 OF THE PAYMENT. PART 2 OF PAYMENT IS PAYABLE TOWARDS THE STUDY COMPONENT OF THE INTERNSHIP PROGRAM AND IS APPLIED FOR UPON APPROVAL INTO THE INTERNSHIP PROGRAM

FINANCE INFORMATION FOR INTERNATIONAL STUDENTS

INTERNSHIP AND COURSE OPTIONS, FEES AND PAYMENT CAN BE DISCUSSED ON AN INDIVIDUAL BASIS. PLEASE EMAIL ACADEMY@YOUTHALIVEQLD.COM FOR THIS INFORMATION.

Declaration *

I UNDERSTAND THAT THIS APPLICATION IS TO BE A PART OF THE YOUTH ALIVE LEADERSHIP ACADEMY INTERNSHIP PROGRAM AND THAT ENROLMENT IN STUDIES WILL BE COMPLETED UPON ACCEPTANCE OF THIS APPLICATION

I AGREE TO HAVE THE YALA INTERNSHIP FINANCIAL COMPONENT OF $500 PAID BY THE CONCLUSION OF TERM 1.