Permanent Zip Code
Date Graduated from High School
Name of College or University
Class Next School Year
Current Place of Employment (if applicable)
What type of career/job would you like to have once you finish your education?
What are your hobbies and interests?
How or from whom did you hear about this program?
Name of person, organization, event or other source*
Relationship To You?
10. Most of the available positions involve long periods of standing, lifting objects weighing at least 25 pounds, and excessive heat. Have you had any injuries, surgeries, or other health conditions that might require special placement or accommodations?
11. Do you play any musical instruments or sing in public? Have you used these talents to play or lead singing in Young Life clubs, or other worship services?
12. Do you think you might bring a car?
13. Have non-prescription drugs, illegal use of prescription drugs, tobacco, vaping, or excessive use of alcohol in the past three months?* If so, please explain:
If yes, are you confident you can refrain from using these substances during the program?
14. Have you ever been arrested?*
If Yes, please explain:
15. Please list your previous work experience, paid or volunteer.
16. Do you have any Young Life camp trips or other commitments you must keep during the program period? Family vacations or other entertainment related trips will not be approved.
17. I have asked the following person to fill out my evaluation:
I agree to keep the following commitments.
a) I will stay for the entire length of the program, unless I prearrange a short leave for school or Young Life reasons. If I have to miss any of the program, I will keep up with the required study.
b) I will attend and be on time to all required meetings, and other functions.
c) I will submit to the program leadership and those in authority at work.
d) I will read the chapter(s) assigned each week, write out answers to the questions, and come prepared to small group discussion meetings.
e) I will spend regular one-on-one time with the leadership.
f) I will work willingly, cheerfully, and to the best of my ability at whatever job I am assigned. I will be at work each scheduled day, unless legitimately sick, be on time, and submit to the authority and regulations of leads and supervisors.
g) I will make every effort to develop closeness and unity with my cabinmates, be open and available to friendships with the entire community, include others in activities and avoid "cliques".
h) I will refrain from the use of tobacco, nicotine, alcohol, and non-prescription or illegal drugs the entire time I am living at either Discipleship Focus property--before, during, or after the program.
i) I will be "non-exclusive" and "non-physical" in relationships, both within and outside the program.
j) I will avoid bringing or using a personal laptop or desktop computer in my cabin during the summer, AND will refrain from bringing my cell phone to required meetings.
k) I will be in my own cabin and in my own bunk by the designated curfew times.
I have read the complete description of this program on the website
Signed* (note, this qualifies as a digital signature):