CYIA Application First Name(required) Middle Initial Last Name(required) Today's Date(required) Address (required) City(required) State(required) Zip Code(required) Contact Information: Student Phone Number(required) Parent Phone Number(required) Student Email(required) Parent Email(required) Emergency Contact Information: filler………………….. Emergency Contact 1 Name(required) Relationship(required) Phone(required) Extra Emergency contact info if needed Emergency Contact 2 Name(required) Relationship(required) Phone(required) Extra Emergency contact info if needed Basic Information: What will be your age by June 1, 2021? (required) Fall 2021 Grade(required) Do you understand that Christian Youth in Action participants are considered to be volunteers? (required) Yes No Do you understand students can be asked to travel anywhere in the State of Montana?(required) Yes No Personal References (We will send Reference form via Email) Pastor/Church Leader Name(required) Email(required) Phone(required) CEF Worker/Christian Adult: Name(required) Email(required) Phone(required) Christian Adult: ….. Name(required) Email(required) Phone(required) Spiritual Information:………………………… Home Church(required) Pastor(required) How did you become interested in and why do you want to be a part of Christian Youth in Action?(required) Personal TestimonyWrite out your testimony of salvation. Explain the scriptural basis for your salvation, when and where you were saved.(required) Understanding I understand that Child Evangelism Fellowship will investigate and verify data given on this application. I authorize all individuals named therein to provide information about me and I release them from all liability for damage in providing this information. I certify that to the best of my knowledge all answers and information given on this application are true and correct. By typing your name into the following box you are agreeing to the statement above and is considered your signature on this document Name Date Submit Application Share this:TwitterFacebookLike this:Like Loading...
