Program Begins in only Past

Youth Rush Application

application.pdf

First Name

Middle

Last

Date of Birth

Will you be at least 18 years of age on or before June 7, 2009?

Yes

Phone Number

Is this your Cell Phone?

Yes

Do you have a valid US Social Security Card?

Yes

Which programs are you interested in?

Magabooks

Bigbooks

SOULS - West

GLOW (Giving Light to Our World)

Youth Rush Application

(Continued...)

Home Address

City

State

Zip

Email Address

Sex:

Male

Female

Marital Status:

Single

Married

Current School Name

School Address

City

State

Zip

Magabook Application 2008

(Continued...)

Where do you plan to attend school next year?

What is your School Major?

How long have you been a Seventh-day Adventist?

Why do you desire to canvass this summer?

Please list your favorite hobbies

Please list your favorite music groups

Magabook Application 2008

(Continued...)

Reference - Work Supervisor

First Name

Middle

Last

Phone Number

Address

City

State

Zip

Reference - Pastor / Teacher / Principal

First Name

Middle

Last

Phone Number

Address

City

State

Zip

By submitting this form you agree that all of the preceding information is correct, to the best of your knowledge.

I Agree

Your application is being submitted, please stand by....

Thank you for your interest.
We will be contacting you soon.

All applicants who are younger than 18 years of age must download and mail or fax us the following application.

application.pdf

Youth Rush Application

Youth Rush Application

Magabook Application 2008

Magabook Application 2008

Your application is being submitted, please stand by....

Thank you for your interest.We will be contacting you soon.

If you have any questions, please call Jason Carlson at: (269) 325-2578

Thank you for your interest.
We will be contacting you soon.