PAACS Core Application Faculty Application PAACS Faculty Application for all applicants including PAACS graduates. If you have any questions or require additional guidance, please contact info@paacs.net Step 1 of 5 20% X/TwitterThis field is for validation purposes and should be left unchanged.Full Name(Required)Preferred NameDate of Birth(Required) MM slash DD slash YYYY Sex Male Female NationalityAfghanAlbanianAlgerianAmericanAndorranAngolanAntiguansArgentineanArmenianAustralianAustrianAzerbaijaniBahamianBahrainiBangladeshiBarbadianBarbudansBatswanaBelarusianBelgianBelizeanBenineseBhutaneseBolivianBosnianBrazilianBritishBruneianBulgarianBurkinabeBurmeseBurundianCambodianCameroonianCanadianCape VerdeanCentral AfricanChadianChileanChineseColombianComoranCongoleseCosta RicanCroatianCubanCypriotCzechDanishDjiboutiDominicanDutchEast TimoreseEcuadoreanEgyptianEmirianEquatorial GuineanEritreanEstonianEthiopianFijianFilipinoFinnishFrenchGaboneseGambianGeorgianGermanGhanaianGreekGrenadianGuatemalanGuinea-BissauanGuineanGuyaneseHaitianHerzegovinianHonduranHungarianI-KiribatiIcelanderIndianIndonesianIranianIraqiIrishIsraeliItalianIvorianJamaicanJapaneseJordanianKazakhstaniKenyanKittian and NevisianKuwaitiKyrgyzLaotianLatvianLebaneseLiberianLibyanLiechtensteinerLithuanianLuxembourgerMacedonianMalagasyMalawianMalaysianMaldivianMalianMalteseMarshalleseMauritanianMauritianMexicanMicronesianMoldovanMonacanMongolianMoroccanMosothoMotswanaMozambicanNamibianNauruanNepaleseNew ZealanderNi-VanuatuNicaraguanNigerianNigerienNorth KoreanNorthern IrishNorwegianOmaniPakistaniPalauanPanamanianPapua New GuineanParaguayanPeruvianPolishPortugueseQatariRomanianRussianRwandanSaint LucianSalvadoranSamoanSan MarineseSao TomeanSaudiScottishSenegaleseSerbianSeychelloisSierra LeoneanSingaporeanSlovakianSlovenianSolomon IslanderSomaliSouth AfricanSouth KoreanSpanishSri LankanSudaneseSurinamerSwaziSwedishSwissSyrianTaiwaneseTajikTanzanianThaiTogoleseTonganTrinidadian or TobagonianTunisianTurkishTuvaluanUgandanUkrainianUruguayanUzbekistaniVenezuelanVietnameseWelshYemeniteZambianZimbabweanPhone NumberType of Phone Number Mobile Number Whatsapp Number Other Preferred Email Address Physical/Mailing Address Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Are you married? Yes No Date of Marriage MM slash DD slash YYYY Spouse's NameSpouse's Date of Birth MM slash DD slash YYYY Please select the PAACS site and program you are applying for:(Required) SiteArusha Lutheran Medical Centre (Tanzania)Bongolo Hospital (Gabon)Centro Evangelico de Medicina do Lubango (Angola)Galmi Hospital (Niger)Harpur Memorial Hospital (Egypt)Hopital Baptiste Biblique (Togo)Hopitaly Vaovao Mahafaly Mandritsara (Madagascar)Hospital of Hope (Togo)Kapsowar Hospital (Kenya)Kibuye Hope Hospital (Burundi)Kijabe Hospital (Kenya)Litein Hospital (Kenya)Malamulo Adventist Hospital (Malawi)Mbingo Baptist Hospital (Cameroon)Nkhoma Mission Hospital (Malawi)Soddo Christian Hospital (Ethiopia)Tenwek Hospital (Kenya) Program Please enter your specialty/subspecialty:(Required)Please list schools you have attended, in order: Date Started Date Completed School Name School Address Diploma Received Actions Edit Delete There are no Schools. Add School Maximum number of schools reached. Describe any medical training you received after graduating from medical school: Starting Date Current Place of Training? Ending Date Hospital or Institution Name Hospital or Institution Address Certification Received Actions Edit Delete There are no Training Programs. Add Training Program Maximum number of training programs reached. Please list the places you have worked since graduation: Start Date Currently Employed? End Date Hospital or Institution Name Hospital or Institution Address Position Held Actions Edit Delete There are no Workplaces. Add Workplace Maximum number of workplaces reached. Please describe any surgical TEACHING experience you have had in the past: Start Date Current Place of Employment? End Date Hospital or Institution Name Hospital or Institution Address Position Held Actions Edit Delete There are no Positions. Add Position Maximum number of positions reached. Please describe any surgical TEACHING experience you have had in the past: Start Date Current Place of Employment? End Date Hospital or Institution Name Hospital or Institution Address Position Held Actions Edit Delete There are no Positions. Add Position Maximum number of positions reached. Are you born again?(Required) Yes No Are you willing to discuss this? Yes No Have you ever led a person to faith in Jesus Christ?(Required) Yes No Please describe how you share Christ with your patients now:(Required)What is the name and location of the church you currently attend?(Required)Do you have a ministry in your church?(Required) Yes No Please describe your ministry:Are you willing to actively participate in the training of the PAACS trainees at your hospital, AND to participate in helping them grow into mature Christians, even if you are not paid by PAACS for doing it?Consent(Required) I agree.Are you willing to actively participate in training the PAACS trainees at your hospital, AND to actively participate in helping them grow into mature Christians, even if you are not paid by PAACS for doing it?PAACS requires three references, one of a pastor, and one of two others, such as supervisors or professional colleagues. Please enter their contact information below. Each person will receive an email from PAACS with a link to our online recommendation form as well as a downloadable version. Please give us the contact information of your pastor and two references: Please select your releation to this person: Please enter their name: Please enter their email: Please enter their mailing address: Please enter their phone/mobile number: Phone Number Type: Actions Edit Delete There are no Entries. Add Entry Maximum number of entries reached. You are required to submit a 500+ word testimony. Please select how you would like to submit it: File upload Typed directly into form Please upload your testimony: Drop files here or Select files Accepted file types: jpg, gif, png, pdf, doc, docx, Max. file size: 128 MB. Please type your testimony below. Please ensure it is at least 500 words. PAACS STATEMENT OF BELIEF • We believe that the Bible, in its entirety, is the only inspired, inerrant Word of God. • We believe that there is one God eternally existent in three persons: the Father, the Son, and the Holy Spirit. • We believe that Jesus Christ is God the Son, born of a virgin, who willingly died on the cross for the sins of all people and rose from the dead to sit at the right hand of the Father. • We believe all of mankind is by nature sinful and consequently separated from God. • We believe that the forgiveness of sin and the gift of eternal life come only through repentance and faith in Jesus Christ. Those who have repented and have placed their faith in Jesus Christ are born again believers. • We believe the Holy Spirit, as a person of the Godhead, is sent by Jesus Christ from God to convict the world of sin. He regenerates those who repent of sin and believe in Jesus Christ. The Holy Spirit instantly indwells believers, becomes their teacher, and empowers them to live a life pleasing to God. • We believe in the personal return of Jesus Christ to reign in power and glory on the earth and to judge all people. Those who have believed in Christ will receive eternal life. Those who have not will be eternally separated from God. • We believe in the unity of all believers. They share the common goal of together becoming fully devoted followers of Christ who love, worship, and obey Jesus Christ as the Son of God. • We believe that it is the responsibility of all believers to proclaim His gospel, make disciples of all nations, and respond with compassion to the suffering of all people in the ways that Jesus did. Please accept my application to become a PAACS faculty member. I agree to all the terms and conditions stated herein.Signature(Required)Today's Date(Required) MM slash DD slash YYYY Section BreakDo you have a birth certificate?(Required) Yes No Birth Certificate Drop files here or Select files Accepted file types: jpg, gif, png, pdf, doc, docx, Max. file size: 128 MB, Max. files: 3. Marriage license Drop files here or Select files Accepted file types: jpg, gif, png, pdf, doc, docx, Max. file size: 128 MB, Max. files: 3. Please upload copies of all diplomas and certifications. PAACS Graduates: Please upload all diplomas and certifications since having entered the PAACS program.(Required) Drop files here or Select files Accepted file types: jpg, gif, png, pdf, doc, docx, Max. file size: 128 MB. Please upload a letter from your pastor confirming that you are an active member in good standing at your local church.(Required) Drop files here or Select files Accepted file types: jpg, gif, png, pdf, doc, docx, Max. file size: 128 MB. Please upload your curriculum vitae.(Required) Drop files here or Select files Accepted file types: jpg, gif, png, pdf, doc, docx, Max. file size: 128 MB. Are you a PAACS graduate?(Required) Yes No Please upload a letter of recommendation from your church pastor or board: Drop files here or Select files Accepted file types: jpg, gif, png, pdf, doc, docx, Max. file size: 128 MB. Please upload a letter of evalution of clinical skills from your chief of surgery (or other supervising surgeon) Drop files here or Select files Accepted file types: jpg, gif, png, pdf, doc, docx, Max. file size: 128 MB. Please upload a letter of evaluation of clinical skills from a peer: Drop files here or Select files Accepted file types: jpg, gif, png, pdf, doc, docx, Max. file size: 128 MB. Please upload a color photograph:Accepted file types: jpg, gif, png, pdf, doc, docx, Max. file size: 128 MB.
