Email Address

Cell Phone Carrier (Sprint, AT&T, Verizon etc)

Place of Employment

Have You Committed Your Life to Christ?

How Long Have You Attended New Life?

Have You Attended Growth Track?

Have you even been charged with, indicted for, or pled guilty to any offense involving a minor?

List all other churches you have attended in the past 5 years.

How often would you like to serve?

What times do you prefer?

Experience and Personal Reference

List any previous church or non-church experience involving children or youth.

Organization Name

City/State

Type of work?

Personal Reference (not a relative)

First Personal Reference:

Name and Email.

Second Personal Reference

Name and Email

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