JESUS YOUTH FULLTIME VOLUNTEERS

APPLICATION FORM

Please answer the questions below and the completed form to be submitted online.

The answers to these questions will help us to assess whether or not a Programme like this would be suitable for you, as well as to
create a curriculum that would bring maximum benefit to those who attend the Programme.

First name . . . . . . . . . . . . . . . . JERRIN

. . . . . . . . THOMAS
. . . .. . . . . . . . . . . . . . . . . . . . . . . . Last name . . . . . . . . . .PANACHAKEL
......................

Panachakel House, Kottamukal, Nalanchira,

Permanent Address .....................................................................................................................................................................................

Trivandrum.
.....................................................................................................................................................................................................................

695015
Pin Code ......................................................................................................................................................................................................

+91 9496 3666 97

Tel /Mob .......................................................................................................................................................................................................

+91 9447 9295 41

Alternate contact Number ............................................................................................................................................................................

jerrin.panachakel@gmail.com
E-mail ..........................................................................................................................................................................................................

Date of birth . . 17-04-1990

................................. Age . . . . .23
..........

Occupation . . .Student
................................. Sex: Male / Female

Father’s name . .Dr.

. . . P.G.
. . . . .Thomaskutty
...................... Professor
Father’s occupation .................................................................................

Mother's name . Dr.

. . . .Mary
. . . . . .George
...................... Professor
Mother's occupation ................................................................................

St. Thomas Malankara Catholic Church, Nalanchira, Trivandrum

Name of your Parish ....................................................................................................................................................................................
Major Archbishops of Trivandrum
Name of your Diocese .................................................................................................................................................................................

Rev. Dr. Shajan Geevarghese Kuttiyil, +91 8281 2432 24

Parish Priest’s name & Contact No .............................................................................................................................................................

Trivandrum Zone
Name of your Zone/Region..........................................................................................................................................................................
Jerald 9995254708
Zonal / Regional JY Coordinator’s Name & contact No ...............................................................................................................................

While i was in high school,

When did you attend a JY Initiation program or Charismatic retreat? .........................................................................................................

Seeker
What is your present role in Jesus Youth? .................................................................................................................................................

Nearly an year and a half

How long you are actively involved in Jesus Youth? ...................................................................................................................................

Ministry in which you are actively involved .................................................................................................................................................

JY Group @CET, Trivandrum

Have you ever attended any JY formation programmes? If Yes, mention the programme..........................................................................

Which Fulltimers training would you like to attend? National English / National Hindi / International

Where do you like to go for mission in your commitment year? Inside Kerala / South India / North India / North East
 GENERAL INFORMATION
1. What kind of an educational background do you have?
(Post Graduate, Graduate, Technical, Engineering, Medicine, Other)
Engineering (M.Tech. Scholar)
................................................................................................................................................................................................

2. What languages can you speak & understand? How well do you speak them? Please put appropriate number
after each language.

(1 = fluent, 2 = can converse and understand almost everything, 3 = can hold simple conversation, 4 = very little)

2
English ......................................................................................................................................................................................................

3
Hindi ..........................................................................................................................................................................................................

Malayalam: 1
Other language .......................................................................................................................................................................

3. How will your Fulltime Volunteers training fees be covered? (i.e. through personal savings, from parents, etc...)
M.Tech. Stipend
................................................................................................................................................................................................

4. When and from whom did you heard about Fulltime volunteers training?
From my father
................................................................................................................................................................................................
................................................................................................................................................................................................

5. Do you have any special abilities or talents that could be utilised during the training? (Eg. singing, musical
instruments, nursing/first aid, driving etc...) Please state them:
Have given reflections about Bible passages at many places
................................................................................................................................................................................................
I play keybaord
................................................................................................................................................................................................
................................................................................................................................................................................................
6. Does your parents support your decision to attend JYFT?
I am allowed by my parents to attend JYFT but only for 3 months
................................................................................................................................................................................................

7. Is there anything about yourself that you would like us to know?

I am visually impaired. Vision on both eyes: 6/18 with restricted ocular movements
................................................................................................................................................................................................
................................................................................................................................................................................................

8. Whom to contact in case of emergency?

Dr. P.G. Thomaskutty
Name ...........................................................................................................................................................................
Panachakel House, JKottamukal, Nalanchira, Trivandrum. 695015
Address .......................................................................................................................................................................
Tel No: 9447929541
......................................................................................................

9. Do you suffer from any sickness? Yes □ No □✓

If yes, please describe

10. Are you under any medication? Yes □ No □

✓

11. Are you ready to take one year fulltime commitment as Jesus youth fulltime volunteer after the training?

Yes □ No ✓
(Please answer Questions 1 to 8 in detail - in less than 50 words for each question)

1. Have you ever consciously committed your life to the Lord?

Yes, I have. I strongly believe that it is God who has been

and is guiding me in my life and He has a great plan for me.

2. Describe how and when.

During my college days, I started to tread away from God,

I started to find reasons to hate Him and then, it was one of my seniors,
Maria chechi, who rekindled my faith and brought me back to God.

3. Describe your present walk with the Lord.

I have a strong faith that God is with me always and He is guiding me.
4. Describe a few important events which made an impact on your spiritual life.

My first confession, first Holy Communions, and

recently the counseling at the three day retreat on Dec.2013
at Mar Baselios College of Engineering and Technology, Trivandrum.

5. Why do you want to attend the JYFT and what would you like to see happen in your life during the programme?

I can know God closer, learn, if He wishes, what He wants from me, know His plans for me.

6. Do you have experience in Jesus Youth leadership of any kind? If so, please give details.

No

7. Describe your relationship to your parents.

They are my friends, my care takers, my mentors, my gurus, my everything,.

8. Describe your relationship to the opposite sex.

I am as comfortable with women as with men.

In the same way as i have friends and brothers, not by blood,
i have women friends and sisters.
And by God's grace, there are a few women who love me and care me as a brother.
9. Please indicate your strengths / weaknesses in the following areas:
(Low) 1 2 3 4 5 (High)

Self discipline □ □ □ □
✓ □
Self confidence □ □ □
✓ □ □
Willingness to learn new things □ □ □ □
✓ □
Adaptability □ □ □ □
✓ □
Tactfulness □ □ □
✓ □ □
Perseverance □ □ □ □
✓ □
Dependability □ □
✓ □ □ □
Punctuality □ □ □
✓ □ □
Cooperation □ □ □ □
✓ □
Communication skills □ □ □ □
✓ □
Ability to work through personal conflicts □ □ □
✓ □ □
Ability to handle discouragement □ □ □
✓ □ □
Ability to handle pressure □ □ □
✓ □ □
Ability to handle anxiety, worry □ □ □
✓ □ □
Consistency between words and actions □ □ □ □
✓ □
Emotional stability □ □ □
✓ □ □
If you wish to expand on any of the above please do so in the space provided:

.....................................................................................................................................................................................................................
.....................................................................................................................................................................................................................
.....................................................................................................................................................................................................................
.....................................................................................................................................................................................................................
.....................................................................................................................................................................................................................

Please print out the "Confidential Reference Form" twice, and give one copy to your spiritual director / Mentor/ guide and another to
a Jesus Youth Leader/ Service team member who knows you well. Kindly state their names, addresses and their relationship to you
below:

Rev. Fr. Dominic Zavio O.I.C., Asst. Vicar, St. Thomas Malankara Catholic Church
1.Spiritual Director/Mentor/Guide ...............................................................................................................................................................

.....................................................................................................................................................................................................................

.....................................................................................................................................................................................................................

2. Jesus Youth Leader/ Service team Member ............................................................................................................................................

Mr. Anoop Joseph Babu

.....................................................................................................................................................................................................................

.....................................................................................................................................................................................................................
CHECK LIST / ONLINE APPLICATION FOR JYFT

1. JYFT APPLICATION FORM COMPLETED AND DULY SIGNED

✓
2. CONFIDENTIAL REFERENCE FORM - FROM YOUR SPIRITUAL DIRECTOR/ GUIDE / MENTOR
3. CONFIDENTIAL REFERENCE FORM - FROM A JESUS YOUTH LEADER OF YOUR REGION
4. SCANNED COPY OF PASSPORT SIZE PHOTO
✓
✓COPY OF PLUS TWO MARK LIST AND DEGREE MARK LIST
5.

Declaration

I...........................................................................................................................,
Jerrin Thomas Panachakel hereby state that the above mentioned informations is
true and correct to the best of my knowledge and belief.

Date . . . .16/01/2014
................................. Signature ......................................................................................................

Please note: Due to a number of factors, we cannot always assure that every applicant will be accepted. We will consider your
application once we have received your completed application form, both reference forms, mark lists as well as passport size photo.

Thank you for your cooperation. We look forward to hearing from you!

Fulltime Volunteers Office

Jesus Youth, Emmaus
HMT Colony P.O., Ernakulam, Kerala
Ph : 04842558631, Mob: 9072151819
fulltimers@jesusyouth.org