Student Leadership Application

Personal Information:

First Name

Last Name

Email

Phone Number

Home Address

Apartment, suite, etc.

City

State

Zip/Postal Code

School

Grade

Birthdate

Social Media

Parent First Name

Parent Last Name

Parent Phone Number

How long have you been attending Youth Group?

Is Discover Church your home church?

Yes

No

Which church do you attend?

Who is your small group leader at Discover Youth?

(former pastor, teacher, boss, friend, etc.)

Reference 1 First Name

Reference 1 Last Name

Reference 1 Phone Number

Reference 1 Relationship to You

Reference 2 First Name

Reference 2 Last Name

Reference 2 Phone Number

Reference 2 Relationship to You

When did you accept Jesus as your personal Savior?

Why do you want to be a Discover Youth Student Leader?

Write down your personal experience with Jesus Christ. (Testimony/Story)