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    We are excited that you are interested in serving at Regenerate Church. Please complete the application below and we'll contact you shortly.

    Name *

    Gender *

    MaleFemale

    Address *

    City *

    State *

    Zip code *

    E-mail *

    Phone*

    Birthday *

    School

    Is Regenerate Church your home church? *

    YesNo

    Which Regenerate Campus do you attend?

    How many years have you attended Regenerate?

    How many years have you been a Christian? *

    Please explain how you became a Christian: *

    What churches have you been a part of and for how long? *

    Please indicate which day(s) you are available to serve at Regenerate Church:

    Sunday

    Are their any potential conflicts in your schedule that would interfere with your commitment? If yes, please list:

    REFERENCES*

    Reference #1

    Reference #2