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Staff Application

Last Name:
First Name:
Middle:
Address:
City:
State:
Zip Code:
Phone
Birth date:			- (Four Digits Please) -
SSN:
Marital Status:

Education: (Include High School, College, CEU's, and any organizations you belong to.)

Write a brief paragraph giving your Christian experience. Tell when you became a Christian and describe your present relationship to Jesus Christ:

What experience have you had working with teenagers?

Have you had any legal problems that would keep you from agreeing to a background check from the Kansas Bureau of Investigation?

What kinds of Christian ministry and service have you been involved in? (If you would like an e-mail verification of this application, PLEASE INCLUDE YOUR E-MAIL ADDRESS below.)

By clicking the Submit button below, you virtually sign your application and agree to the following statement:

"I do solemnly promise that the information submitted above it correct to the best of my knowledge."

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