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Partnering with Young Life in Discipleship

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Enter Date*

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First Name*

Last Name*

Preferred Name




Zip Code*

Your Email*

Is email a reliable way to contact you?

We will primarily use email to correspond with you. Please make sure we are on your safe senders list. All our correspondence will come from the following e-mail address:

Current Phone*

Permanent Address

Permanent City

Permanent State

Permanent Zip Code

Permanent Phone

Other Email

Home City

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Date Graduated from High School

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Class Next Year


Career Leading

Shirt Size

What are your hobbies and interest?

From whom did you hear about this program?

Full Name

Relationship To You?

Preferred Location

Why This Location?

Tell us a little bit about yourself

1. How long have you been a Christian? Share the highlights of your spiritual journey since becoming a Christian, being honest about your high points and low points. Especially share your experience this past year.

2. What is your definition of a Christian?

3. Why do you want to be in this program?

4. Explain two of your strengths and two weaknesses. (This is not to determine acceptance. Please be honest)

5. Please check the traits you feel best describe you and add others not listed

Shy or quiet, but warm to othersOutgoingFun LovingSelf AssuredLoud and BoisterousDisciplinedStruggles with AuthorityCritical SpiritBold or DirectEasy GoingKeeps room neatMessy Room OKMoodyGood Social SkillsLacking in Social SkillsPopular with PeersSmall group of good friendsVery Few friendsRelates well with Adults

6. Young Life Involvement

YL ClubYL Volunteer LeaderYL CampaignersYL Student StaffYL Camp

7. What, if any, college ministries have you participated in?

The leadership team wants to minister to you in every possible way, so we prayerfully assign housing and small groups. Your answers to the following two questions will help us.

8. Please describe your immediate family and how they have influenced your life.

9. Please share any past problems, or struggles you are dealing with now, or any information about your background or family that will help us know you and serve you better. This information will be kept confidential.

10. Most of the available positions involve long periods of standing and lifting objects weighing at least 25 pounds. Have you had any injuries, surgeries, or other 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 drugs, tobacco, or excessive use of alcohol been part of your lifestyle 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 assignments or other commitments you must keep during the program period?

17. I have read the complete description of this program on the website

18. I have given the evaluation form to:

I am willing 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, alcohol, and drugs, the entire time you are living at either property-before, during, or after program.

i) I will be "non-exclusive" and "non-physical" in relationships, both within and outside the program, as outlined in the commitments section.

j) I will be in my own cabin and in my own bunk by the designated curfew times.

Signed* (note, this qualifies as a digital signature):

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