We are excited that you are interested in serving at Regenerate Church. Please complete the application below and we'll contact you shortly.
Full Legal Name *
Gender *
MaleFemale
Address *
City *
State *
Zip code *
E-mail *
Phone*
Birthday *
School
Parent(s) names or legal guardian (if under 18)
Do you have any problem with the following? If yes, please explain:
Food
Traveling
Are there any physical conditions that would hinder you from participating or is of a concern? *
YesNo
If yes, please explain:
Do you have any allergic reactions or take medications? *
YesNo
If yes, please explain:
Do you have a passport? If no, please apply for one immediately *
YesNo
Do you have your birth certificate? *
YesNo
How many years have you been a Christian? *
Is Regenerate Church your home church? *
YesNo
Which Regenerate Campus do you attend?
How many years have you attended Regenerate?
Please explain how you became a Christian: *
What churches have you been a part of and for how long? *
Do you agree and hold to the same doctrine of Regenerate Church? *
YesNo
Do you believe the bible is the inspired and authoritative Word of God? *
YesNo
Do you currently have any struggle with substance abuse or addictions? *
YesNo
Please explain why you are interested in going on this mission’s trip: *
Have you ever been on a previous missions outreach with Regenerate Church? *
YesNo
If yes, where?
Have you had any previous experiences in missions with any other church or organization? *
YesNo
If yes, where?
Have you ever served in any area of ministry before? *
YesNo
If yes, please explain:
REFERENCES *
Reference #1
Reference #2
EMERGENCY CONTACT *

The information contained in this application is correct to the best of my knowledge. I authorize any references listed in this application to give you any information that they may have regarding my character and fitness for missions.

On this trip, I will submit to the leadership of Regenerate Church. And if my application is accepted, I understand the influence my private life can have on others and therefore I will keep my life as an open book and be honest to the leadership.