43Rd SHIP for SOUTHEAST ASIAN and JAPANESE YOUTH PROGRAMME (SSEAYP) 2016

CONFIDENTIAL

APPLICATION FOR 43rd SHIP FOR SOUTHEAST ASIAN AND JAPANESE YOUTH PROGRAMME (SSEAYP) 2016 NATIONAL LEADER / PARTICIPATING YOUTH

Notes 1 Please read the general information and instructions on the back pages before completing the application form. 2 The application form must be completed neatly in block letters. 3 Applicants nominated by an agency must have their forms endorsed (section 6); applicants without a nominating organisation must submit a written testimonial together with their completed form. 4 Please return the completed nomination form to the National Youth Council at [email protected] (Attn: Ms Nurul Russyiedah Sani, International Affairs)

APPLICATION FOR THE POSITION OF: (please select only ONE) National Leader : Participating Youth : 1. PERSONAL PARTICULARS Name as in NRIC (underline surname) Alias (if applicable) * Dr/Mr/Mrs/Miss/Mdm Affix recent passport size photograph here Home Address Home Tel No.

Email Address Mobile No. Marital Status

Name and Address of Employer/School Designation

Nationality NRIC No. Passport No.

Country of Birth Date of Birth Passport Date of Issue

Religion Race Passport Date of Expiry

Please state your dietary preferences due to religious reasons or dietary restrictions / food allergies.

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2. EDUCATIONAL BACKGROUND (in chronological order) Schools/Institutions and Country Highest Standard Passed Year

Type and Duration of Awards/Scholarships Held

3. KNOWLEDGE OF LANGUAGES AND DIALECTS Written & Spoken Written Spoken

4. BACKGROUND ACTIVITIES OF NOMINEE (in chronological order) Extra-Curricular Activities in Position Held Period of Involvement Clubs / Associations / Societies

Involvement in volunteering/ community Position Held Period of Involvement projects/ overseas exchange programmes

Have you been previously nominated for or participated in any NYC youth programme? If yes, please state the name of the programme(s), the year of participation and your level of involvement (e.g. participant, chairperson, co-leader).

5. EMPLOYMENT HISTORY Name of Previous Employers Date Joined Date Left Designation / Nature of Employment

Name of Present Employer Date Joined Designation / Nature of Employment

6. NOMINATOR'S INFORMATION [For Applicants nominated by an Organisation] *Please note that NYC may contact the Nominator when necessary. Name and Address of Nominating Organisation Duration of Nominee’s Involvement in the organisation

Nominee's main area(s) of involvement in Nominating Organisation (in chronological order)

Name of Nominator Tel (O) : Mobile: Email:

Nominator’s Position in Organisation Stamp of Nominating Organisation / Signature of 2 CONFIDENTIAL CONFIDENTIAL

Nominator

7. CHARACTER REFEREES (Please provide particulars of two persons who are not related to you. They should be responsible persons who know you well with regard to your character and voluntary work. NYC may contact the referees stated.) Name of Referee (1) Name of Referee (2)

Email Address Email Address

Contact No. Contact No.

Organisation/ Designation Years Known Organisation/ Designation Years Known

8. OTHER INFORMATION How did you hear about SSEAYP?

□ Word of Mouth (please specify) ______

□ I have not heard of SSEAYP until my nomination

□ Others (please specify) ______

How do you think you can contribute to SSEAYP?

What do you hope to gain/learn from SSEAYP?

Please indicate your interest in the areas provided in the box below. The information would allow NYC to invite you to participate in other NYC programmes based on your interest or expertise where appropriate or relevant.

Area of Interest Please tick to Please highlight any special indicate your interest knowledge/skills or training in the area

Arts, Culture & Heritage  Business and Entrepreneurship  Community and Social Services  Education and Employment  Environment  Food and Nutrition Education  Health Issues  Information and Media  International Relations  Sports and Adventure  Youth Activism and Causes  Others: ______

9. EMERGENCY CONTACT (NEXT OF KIN) 3 CONFIDENTIAL CONFIDENTIAL

Name Relationship

Address Home Tel No. Mobile No.

10. MISCELLANEOUS 1 Have you suffered, or are suffering from any medical condition, illness, disease, * Yes/No mental illness or physical impairment?

2 Are you currently using any long-term medication? * Yes/No

3 Do you have a criminal record1 in Singapore? * Yes/No

4 Have you ever been convicted of a criminal offence in a court of law in any * Yes/No country for which the outcome is pending or not? (excluding criminal records disclosed above)

5 Have you ever been declared a bankrupt? * Yes/No

If your answer is “Yes” to any questions above, please give details in the space below and provide documentary evidence.

11. DECLARATION

(1) I give my consent for the relevant Government authorities to obtain and verify information from or with any source, as you deem appropriate for the assessment of engagement with the National Youth Council.

(2) I give my consent for NYC to communicate with me with regard to its youth programmes and activities by electronic mail or any other means which NYC may deem appropriate at my contact details set out in this form.2

(3) I declare that the particulars in this form are true to the best of my knowledge and I have not wilfully suppressed any material fact. I accept that if any of information given by me in this application is in any way false or incorrect, my service with NYC will be terminated without any notice.

Signature of Applicant Date

PARENTAL CONSENT (for applicants under 21 years old)

I, ______*parent/guardian of ______, hereby certify that the information given by the applicant is true and correct. I agree that I will not hold the Organisers liable for any injury, loss or damage that my child may suffer or sustain in the course of or in connection with his/her participation as a volunteer.

Signature of Parent Date

* Please delete accordingly.

1 By this, we refer only to a criminal record of a conviction under the Registration of Criminal Act

2 Here at NYC, we value your privacy. We will keep your details strictly confidential. Please drop us a note at [email protected] if you would like to opt out of all notifications.

INSTRUCTIONS

1. Before you complete the application form, please satisfy yourself of your eligibility to participate in the Programme. Please refer to:  Annex A – Conditions governing participation as National Leader  Annex B – Conditions governing participation as Participating Youth

2. You are encouraged to attend a sharing session conducted by the NYC and SSEAYP International Singapore on 8 March 2016, 7pm, *SCAPE (HubQuarters, 2 Orchard Link Level 4, Singapore 237978).

3. The application form must be completed in accordance with the instructions on this Form and endorsed by your Direct Supervisor, HR, or the Head of your nominating organisation, where applicable. Failure to comply with the instructions may affect the consideration of your application.

4. Applicants who are NOT nominated by any organisations are required to submit a testimonial, preferably by a person with authority or good social standing, together with the application form. This testimonial should make reference to your character and ability to work as a team and contribute to the Singapore contingent.

5. Application forms need not be accompanied by supporting documents, such as educational certificates and testimonials. The original copies should be brought along for the interview upon request.

6. False particulars or wilful suppression of material facts will render you liable for disqualification.

7. The deadline for submission of the application form is stated below. Late submissions will not be entertained.  Deadline for National Leader Application – By 18 March 2016, 5:00 PM  Deadline for Participating Youth Application – By 22 April 2016, 5:00 PM

8. Only shortlisted candidates will be called for interviews. The National Leader and Participating Youth applicants will be notified by mid April and mid June 2016 respectively should they be selected for the interview. Requests for change in interview dates will not be entertained. .

9. All decisions of the National Youth Council on the selection of candidates are final and no enquiry pertaining to such decisions shall be entertained.

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Annex A

CONDITIONS GOVERNING PARTICIPATION IN THE 43RD SHIP FOR SOUTHEAST ASIAN AND JAPANESE YOUTH PROGRAMME (SSEAYP) 2016

NATIONAL LEADER

1. Based on guidelines given by the programme organiser, nominees for the position of National Leader shall be Singapore citizens preferably aged between 31 and 39 years old as of 1 January 2016.

2. Nominees should preferably be ex-Participating Youths (PYs) or individuals who are deeply familiar with the SSEAYP. Youth leaders or youth officers with a proven track record of active youth, community or public service will be considered favourably.

3. Nominees shall be of good character and have no criminal records.

4. Nominees must possess a good command of the English language, which is the medium used in the Programme.

5. Nominees must be physically fit for extended sea travel and communal living on board the ship. The selected candidate is required to undergo medical and dental examinations at his/her own expense. These reports are to be submitted within three weeks of being informed of the selection after the interview.

6. The selected candidate must be responsible for the arrangements of his/her own medical insurance coverage.

7. The selected candidate shall obtain leave from his/her employer or institution to take part in the programme. He/She shall confirm his/her participation within two weeks of being informed of the selection after the interview and submit to NYC the original documents of proof of leave granted by his/her employer for participation in SSEAYP.

8. The selected Candidate for the position of National Leader will become Singapore’s national representative in the programme and must therefore conduct himself in a manner befitting the national position of an Ambassador for Singapore. He/She will be entrusted with the responsibility of preparing the Contingent to become exemplary youth ambassadors for Singapore.

9. The selected Candidate for the position of National Leader must be able to attend the National Leader’s Meeting in Tokyo for a period of 4 days, tentatively scheduled to take place in mid to late September 2016.

10. The selected Candidate for the position of National Leader must also be able to sit on the Orientation Committee and the Selection Panel for PYs. He/She must be able to participate in the PYs interview session tentatively scheduled on weekends in May or June 2016.

11. The selected candidate for the position of National Leader must be able to commit to all activities pertaining to SSEAYP 2016. These include planning and overseeing the compulsory pre- SSEAYP orientation training from July to October 2016 for PYs and all necessary preparations by the Contingent for SSEAYP, attending official SSEAYP meetings before and during the programme as well as coordinating the post-programme activities.

12. If the selected candidate does not comply with any of the conditions above, he/she may be disqualified from participation.

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Annex B

CONDITIONS GOVERNING PARTICIPATION IN THE 43RD SHIP FOR SOUTHEAST ASIAN AND JAPANESE YOUTH PROGRAMME (SSEAYP) 2016

PARTICIPATING YOUTH

1. Nominees/applicants shall be Singapore citizens between 18 and 30 years old, as of 1 January 2016. Full-Time National Service men (NSFs) are not eligible to apply for the programme.

2. Nominees/applicants should preferably be youth leaders or youth officers with a proven track record of active youth, community or public service.

3. Nominees/applicants shall be of good character and have no criminal records.

4. Nominees/applicants must possess a good command of the English language, which is the medium used in the programme.

5. Nominees/applicants must be physically fit for extended sea travel and communal living on board the ship. All selected participants are required to undergo medical and dental examinations (including chest x-ray and relevant vaccinations) at their own expense. Deadline to submit the completed medical and dental reports will be advised at a later date.

6. All participants must be responsible for the arrangements of their own medical insurance coverage.

7. All participants shall obtain leave from their employers or institutions. They shall confirm their participation within two weeks of being informed of their selection.

8. All participants are required to undergo an intensive orientation programme, which includes evening training sessions on weekdays and a residential weekend session per week. The orientation programme is scheduled to take place from July to October 2016. However, participants should expect to continue with their Contingent preparation and meetings through to their departure date in October 2016.

9. Participants who fail to participate fully in the orientation programme and fulfil their duties assigned by the Contingent shall face expulsion. NYC reserves the right to terminate the participation of candidates who cannot perform their role and contribute to the Contingent.

10. All participants must contribute a sum of S$900 per person to the Contingent Fund for the Contingent’s expenses for the programme. Participants are encouraged to raise funds or approach their nominating organisations to subsidise their contributions to the Contingent Fund. All contributions to the Contingent Fund are strictly non-refundable.

11. All participants must conduct themselves in a proper manner befitting the position of a youth Ambassador for Singapore before, during and after the Programme. This includes being mindful of their speech and behaviour on social media and in their interaction with members of the public and fellow participants of the programme.

12. All participants must return immediately to Singapore with the contingent upon completion of the programme. Participants who conduct themselves dishonourably during the programme will be sent back and will have to bear the cost of travel and any other related cost.

13. Any participating youth who does not comply with any of the conditions above may be disqualified from participation in SSEAYP and NYC reserves the right to penalise him/her from participating in future NYC overseas youth programmes.

14. As part of the requirements for a participating youth, all successful candidates are to fulfil the following in the year after their participation:

a) Knowledge sharing with new batch of PYs including but not limited to attending Pre Departure Training (PDT) sessions;

b) To assist on the next local programme eg: Liaison Officer, Host Family, Planning Committee Member, etc;

c) To complete Post Programme Activity (PPA) within the following year of their return. Participants are encouraged to raise funds for their Contingent’s PPA; and

d) Promote and publicise SSEAYP via NYC’s and Contingent’s networks.

15. Successful candidates are also encouraged to continue supporting NYC in its ongoing initiatives for community building and youth outreach through knowledge sharing, community volunteerism and other similar initiatives.

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8 CONFIDENTIAL