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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.

    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.