Project Timothy Rockies Application

First Year Application Rockies

First Year Application Rockies

Name:

Address:

City:

State:

Zip:

Email Address:

Cell

Church Name:

Senior Pastor's Name:

Youth Pastors/Workers name:

Youth Pastor's Email:

Are you currently a leader at your youth group?

Yes

No

If yes, what do you do?

To attend Project Timothy, you need to commit to serving at your Youth Group in some capacity for the next year. Do you commit to doing this?

Yes

No

Do you commit to paying the $250 fee if you are accepted?

Yes

No

Are you vegan or vegetarian?

Yes

No

PLEASE list any food allergies

What is your T Shirt Size XSSMLXLXXL

Have you ever been convicted of a crime?

Yes

No

If yes, please explain

Have you ever been convicted or accused of child abuse/sexual abuse or been involved in any activities related to molesting/abusing a child or a youth?

Yes

No

If yes, please explain:

Type your name below if all of the above information is complete and true

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