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APPLICATION FORM
Application form for IMPACT 2025
Personal Information
Full Name (as it appears on your passport if you have one)
(Required)
First
Middle
Last
Preferred Name
Gender
(Required)
Female
Male
Unspecified
Email
(Required)
Phone
(Required)
Address
(Required)
Street Address
Address Line 2
City
State/Territory
Postcode
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Date of Birth
(Required)
Day
Month
Year
Languages Spoken at Home (other than English)
Is English your first language?
(Required)
Yes
No
Do you have a disability, impairment or long term medical condition which may impact your participation?*
(Required)
Yes
No
*if YES, we may be in contact to discuss support services and facilities which may assist you
Are you under 18 at the time of application?
(Required)
Yes
No
Name of Parent/Carer
(Required)
First
Last
Parent/Carer Email
(Required)
Emergency Contact
Please give us details for one person we can contact in an emergency
Name
(Required)
First
Last
Phone
(Required)
Email
(Required)
Church
Please provide us with some information about your current church setting
Name of Your Church
(Required)
Name of Senior Pastor
(Required)
Email of Senior Pastor
(Required)
A reference check form will be directed to them
Do you have a mentor already?
(Required)
Yes
No, but I have someone in mind
No, and I would like help finding a suitable mentor
Mentor name
(Required)
Their Email
(Required)
A reference check form will be directed to them
How long have you attended this church?
(Required)
Up to 1 year
1-3 years
3-5 years
More than 5 years
How supportive is your church of you joining IMPACT?
Tell us about your experience at church and any ministries you are a part of
(Required)
Spiritual Journey
Tell us some of your story with Jesus
(Required)
Tell us about your gifts/talents and what kinds of ministries you enjoy engaging in
(Required)
IMPACT
Which IMPACT format are you applying for?
(Required)
Impact Growth
Impact Adventure (Cambodia Trip)
Full Impact
I'm unsure and would like to talk to someone about my options
Would you like more info about applying for any of the following?
Study at Morling College
Vocational Training at Bedford College
Installment Payment Plan
Please select any that apply to you
I have a current passport
(Required)
Yes, an Australian passport
Yes, from a country other than Australia
No
If you don't have a current passport, or your passport expires before December 2025, you will need to apply/renew by the end of March
Passport Number
Passport Expiry
DD slash MM slash YYYY
I have a current Working With Children Check (WWCC)
(Required)
Yes
No
A WWCC is required for several of our outings, including the Mission Exposure Trip, so if you're 18 or older and you don't have one, you will need to apply for one before IMPACT starts
WWCC Number
WWCC Expiry
DD slash MM slash YYYY
What are you looking forward to about IMPACT?
(Required)
Agreement
I agree
By clicking this box I am submitting the information in this form to the IMPACT team to review. You can expect contact from the IMPACT team in the next week to arrange next steps. Please note that the relevant information will be shared with Baptist Mission Australia in preparation for the Mission Exposure Trip. If you have further questions please contact the IMPACT Gap year team via email. impactgap@nswactbaptists.org.au
