Smartphone Media Training Registration Smartphone Media Training Registration Please fill out this form to register for the Smartphone Media Training. Email sam@createmobile.org if you have any questions. Step 1 of 4 25% Which Smartphone Media Training are you registering for?(Required) Jinja, Uganda (2025) Other Application Requirements(Required) I understandThis application requires a recent photo of myself, a photo of my passport or ID, and an email address for a church/ministry reference.Name(Required) First Last Email(Required) Phone Number(Required)Please include your full number and country code.Messaging Apps WhatsApp Telegram Signal Line Other Mark the applications we can reach you at with the phone number you provided. (Mark all that apply.) Gender(Required) Male Female Marital Status(Required) Single Married Other (Engaged/Widowed) Country of Residence(Required) Date of birth(Required) Day Month Year Upload Your Photo:(Required)Please select a small .jpg photo that clearly shows your faceAccepted file types: jpg, jpeg, png, Max. file size: 10 MB. Picture IDIf you are traveling internationally to attend this training you are required to upload a passport photo as your ID. If you do not currently have a passport, but plan to get one to attend this training please use another ID and let us know your intentions.What form of ID will you provide? Passport National ID Driver’s License Other ID We will need you to upload a picture of your ID.Picture of ID(Required)Accepted file types: jpg, jpeg, png, gif.Please take a picture of your full Passport photo page or the front of your other ID.Country of Birth(Required) Citizenship(Required) Passport Nationality Passport Number Emergency Contact (EC) Name:(Required) EC's Country:(Required) EC's Relationship to you:(Required) EC's Best Phone Number:(Required) EC's Best Email:(Required) Your Facebook name (if any)Your Instagram name (if any)How did you learn about this training?(Required) A friend referred me Online advertising Website Other (please explain) Name the friend, website, or other way(s) you learned about this training.(Required) Have you traveled to the country where this training is being offered?(Required)YesNoIf yes, when were you there? What is your level of comprehension in English?(Required)English comprehension will help students complete the FFS. Very Low Beginner Intermediate High List other Languages You Speak/Understand When did you become a follower of Jesus and how is your spiritual life now?(Required)Have you worked with YWAM or another mission before?YesNoProvide detail about when/where/how you worked with YWAM or other mission: Pastor/Reference Name(Required)Please list a pastor or ministry leader who can provide a reference to recommend you for participation in this program. First Last Pastor Email(Required) What do you hope to learn by attending this training?What else should we know about you that could help us teach more effectively?Tell us about your smartphone(Required) Share the brand and model number for your smartphone. (Example: Samsung Galaxy A20) If you do not have a smartphone, can you attend this training with someone who will share their smartphone with you? If you do not have any phone now, let us know. Also, share about any other equipment you will bring.Can you meet the financial obligations for this trip, including any visa/flight costs? Tell us about how you serve with your church/ministry (and share the ministry's name) Confidential Health Questions – Do you now have (or have had) any of these health issues? Hepatitis Diabetes Ear, Eye, or Skin Trouble Recurring headaches Allergy to a medication Other life-threatening allergies to foods/bees Heart disease Mental/Nervous Disorders Asthma High blood pressure Epilepsy HIV/AIDS Other (Detail below) Please detail health issues that might hinder your ability to participate in our rigorous Smartphone Media Training and share if you're currently under the care of a doctor/nurse:Have you been tested for HIV? Share about any mental health issues for which you have received counseling or take/took medication to resolve Vaccinations Cholera Yellow Fever Hepatitis A Hepatitis B Measles Typhoid Tetanus Covid-19 I have chosen not to receive the recommended vaccines/injections Please complete the requested information below. Upon acceptance, we recommend you obtain the following immunizations/injections (before arrival): typhoid, hepatitis A, hepatitis B, and tetanus booster (if you have NOT received one in the last 5 years). These are usually recommended by health agencies (Center for Disease Control, etc.) regardless of where you travel. Due to the varied outreach locations, other immunizations, injections and malaria medication may be recommended and can be obtained before outreach. If you have ever been vaccinated for cholera, typhoid, or yellow fever, please check the box below and bring that information with you. If you were born after 1957, you will need a measles booster (total of 2 measles immunizations). Those born before 1957 are considered immune from measles. Please be prepared financially to cover the cost of additional injections. If you decide NOT to receive the recommended immunizations/injections, you will be asked to sign a waiver stating that you understand the specific immunizations/injections recommended and are choosing not to obtain them. Please check the box below if you are NOT obtaining the recommended immunizations/injections.*I Agree:(Required) I declare all information disclosed in this application form to be true and correct. I have not withheld any relevant information.I Have Read and Agree with the Foundational Values:(Required)Create International Foundational Values: 1) Every person has a right to receive a clearly understood presentation of the Gospel of Jesus Christ. 2) The gospel message should be shared amongst all unreached people groups. All of our ministry efforts should focus on this pursuit. 3) Appropriate and innovative art and media resources should be produced to share the gospel and to mobilize the church to complete the Great Commission. 4) Culturally appropriate forms of art and media should be used to effectively communicate and build bridges for the Gospel through careful contextualization. 5) Contextual communication resources should be gathered and distributed to serve the Body of Christ and to mobilize the church toward greater engagement with unreached peoples. 6) Workers should be trained and raised up to use media for missions to unreached peoples. 7) We value unity and partnership within the ministry of Create International. It is our desire to function as an international body of teams that would support each other in every way. I AgreeRelease Statement(Required) Please check this box to absolve YWAM, Create International, Create Mobile, and any of its ministries, of all liability while taking the class or working on projects for the class. “As a participant in a YWAM, Create International, or Create Mobile, I hereby release them from any liability or responsibility for injury to me of any kind, including but not limited to bodily injury, emotional distress, or economic loss that I may sustain, or may otherwise occur, while I am acting as a student of my own free will. I voluntarily assume any and all risks of being detained and/or incarcerated by the authorities of the country or countries where I travel while engaged in my voluntary duties on behalf of YWAM, Create International, or Create Mobile. I agree to hold YWAM, Create International, or Create Mobile harmless in all respects if that should occur.”What payment method can you use to pay for this training? Bank Transfer or Paypal Online (Credit/Debit) Cash (on arrival) Describe any scholarship or financial needsIMPORTANT: This is only an application form, and is subject to approval by the Create Mobile team. We occasionally offer scholarships to help students cover fees, however our training is not offered completely free. Please wait a few moments for a confirmation notice to appear after you hit the submit button before leaving the page. Δ