apply Apply for Mission Year Step 1 of 7 14% Personal InformationFull Legal Name* First Last Please enter your name as it appears on your driver's license or state ID.NicknameIf you go by a different first name than the one above, enter it here.Email* Primary Phone #*Twitter-inactivefieldAddress* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Gender*Sexual Orientation (optional)Ethnicity*Birthdate* Date Format: MM slash DD slash YYYY Church Name-inactivefieldDenominational Affiliation*Church Address-inactivefieldPastor Name-inactivefieldEmergency 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. Save and Continue Later Program Application InformationHow did you hear about us?*Alumni or current team memberFriendFamily MembersPastorShane Claiborne or The Simple WayLeroy BarberBart CampoloTony CampoloConference/FestivalStaffInternet SearchSocial MediaAdvertisementOtherTell us more about how you heard about us.Application Year*20192020ARTS team-inactive fieldYesNoAre you available for the full length of the program, beginning September 3, 2019 and ending July 24, 2020?*YesNoShare 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. Save and Continue Later Wellness InventoryDo you have or have you had any significant physical conditions of special limitations (climate, diet, exercise, stamina, eating disorder, depression, prescription medication)?*YesNoIf yes, please specify.Have you ever seen a counselor or therapist for any reason (including addiction)?*YesNoIf yes, please provide a brief explanation (your answer will be held confidential and is only for our internal use).Regardless of counseling, have you ever suffered any type of abuse?*YesNoHave you ever been accused of any kind of abusive behavior?*YesNoHave you ever been arrested?*YesNoThis question can include any violation (other than a minor traffic violation) that resulted in a conviction, a plea of guilty, or no contest, probation, community service, a summary report, or some other form of adjudication. Also includes any pending charges or if you are under any type of legal investigation. Save and Continue Later Education and Employment HistoryPlease 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 yourselfAccepted file types: jpg, gif, png.SchoolGraduation Year or Current Year in SchoolMajor (if applicable)Minor (if applicable)-inactivefieldPlace of EmploymentTitleYears with Company Save and Continue Later Short Answer QuestionsTell 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. Save and Continue Later ReferencesTHIS 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*CoachCounselorFamily FriendMentorMission Year AlumPastorProfessor/TeacherSupervisorOtherEmail PhoneReference #2 Name*Relationship*CoachCounselorFamily FriendMentorMission Year AlumPastorProfessor/TeacherSupervisorOtherEmail Phone Save and Continue Later Applicant AgreementTo 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* Save and Continue Later This iframe contains the logic required to handle Ajax powered Gravity Forms.