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Personal Information
Full Legal Name*
First Last
Please enter your name as it appears on your driver's license or state ID.
Nickname
If you go by a different first name than the one above, enter it here.
Email*
Primary Phone #*
Twitter-inactivefield
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Gender*
Sexual Orientation (optional)
Ethnicity*
Birthdate*
Church Name-inactivefield
Denominational Affiliation*
Church Address-inactivefield
Pastor Name-inactivefield
Emergency Contact Name*
Enter the full name of someone who we can contact in case of emergency.
Emergency Contact Phone*
Please enter a phone number for your emergency contact person.

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Program Application Information
How did you hear about us?*
Tell us more about how you heard about us.
Application Year*
ARTS team-inactive field
- Yes
- No
Are you available for the full length of the program, beginning September 3, 2018 and ending July 26, 2019?*
- Yes
- No
Share your motivation for applying.*
In one to three sentences, what is your favorite "Christian" book (besides the Bible) and why?*
In one to three sentences, what is your favorite "secular" movie and why?*
Complete this sentence: "I think others would describe me as..."*
In what ways do you see Mission Year being a good fit for you at this point in your journey, and you a good fit for Mission Year?*
Please list the names of any Mission Year alumni you know.

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Education and Employment History
Please upload a resume below OR fill out the education and employment questions. Both are not required.
Upload your resume (optional)
Upload a recent photo of yourself
Accepted file types: jpg, gif, png.
School
Graduation Year or Current Year in School
Major (if applicable)
Minor (if applicable)-inactivefield
Place of Employment
Title
Years with Company

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Short Answer Questions
Tell when and how you became a Christian and what's been happening lately in your journey with God. Be sure to include a description of your involvement in the Christian community, service commitments, and personal formation over the past few years.*
What most excites you about living in the city, building healthy relationships across dividing barriers, serving with a local organization, and engaging in spiritual formation? What about this most worries you?*
What are some of the strengths, previous experiences, and/or skills you have that would positively impact your involvement in each of the following areas: community life, service site, church partnership, neighborhood time?*
How are justice and diversity related to your faith?*
Please add any other information you feel we should know processing your application.

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References
THIS SECTION IS REQUIRED. Please choose two non-family, non-peer persons to provide references for you. References can be pastors, coaches, mentors, professors, etc. They can fill out the form online at www.missionyear.org/reference. If hard copies are needed, please contact us.
Reference #1 Name*
Relationship*
Email
Phone
Reference #2 Name*
Relationship*
Email
Phone

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Applicant Agreement
To the extent of my knowledge, the information on this application is truthful and accurate. I understand that background checks revealing undisclosed evidence of criminal activity and/or child abuse will disqualify me from consideration for Mission Year. By means of this release I authorize Mission Year to make inquiries about me with the people listed in this application.
Name*

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Personal Information