APPLY TO YSAR Please fill in the form to apply for YSAR 2018 YSAR APPLICATION FORM Your DetailsBefore filling in this form, please have a passport photo saved ready to upload. Name* First Last Date of Birth* Email Address* Please enter your email address. This email will be used to correspond with you relating to YSAR mattersHome Phone Number*Home Mobile Number*Work Phone NumberIf applicableAddress* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code 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 GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Please enter your full address. This will enable your year group to arrange for car-pooling to YSAR events. Which YSAR area are you applying for (geographic location)?*TaurangaAucklandYSAR is begining to expand into other regions. Please select where you wish to apply. Why would you like to join YSAR*Please describe in detail why you would like to join YSAR. What are your career/job aspirations when you leave school?This information is valuable to the YSAR administration to assist you in careeer development opportunitiesUpload a Passport style photo*Accepted file types: jpg, jpeg, png, gif, pdf.Upload a photo that show a nice clear headshot of yourself. Maximum size is 5MB.School / Education Organisation / Vocation*What institute are you aligned toAreas of interest Science Technology Engineering Math Innovation - Identifying new solutions List the Science, Technolgy, Engineering and Math (STEM) areas which interest you Your Facebook Profile Please paste your facebook url if you have one. YSAR frequently use the Facebook platform to communicate with studentsMale / Female*MaleFemaleRate your Fitness Level*Please enter a value between 1 and 10.1 being very unfit. 10 being very fit.Skills, experience and knowledge of Search and Rescue and Civil Defence*Not muchSomeExperiencedOutdoor training courses completedGive the name of any outdoor training courses you have completed.Medical conditions and any limitations which may affect your participation in the YSAR programme*Primary CaregiverThe person who is primarily responsible for your daily carePrimary Caregiver's Name*Primary Caregiver's Mobile Number*Primary Caregiver's Email Address* Primary Caregiver's Occupation*Secondary CaregiverThe person who is secondarily responsible for your daily careSecondary Caregiver's NameSecondary Caregiver's Mobile NumberSecondary Caregiver's Email Address Secondary Caregiver's OccupationNon Family RefereeReferee's Name*Referee's Email Address* Referee's Contact Number*MiscellaneousNZQA NumberAny Equipment you have?* Sleeping bag Tent Back pack Day pack Thermal underwear Warm outerwear Gas Cooker Outdoor pots, pans and utensils Head Torch Parka - Wetweather jacket Tramping boots Compass Other Let us know any equipment you have. Don't forget to check out our Gear list in the Resources section of this site if you are thinking about purchasing some.Other gear and equipmentDriver Licence* None Learner Restricted Full Motorcycle UntitledUntitledFirst ChoiceSecond ChoiceThird ChoiceUntitled First Choice Second Choice Third Choice Untitled First Choice Second Choice Third Choice Untitled First Choice Second Choice Third Choice EmailThis field is for validation purposes and should be left unchanged.
