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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.