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Emmaus Application

Scholarship Application

Team Application

Lay Director Application

Chrysalis Application

Sponsorship Kit

Personal Information:
Email Address:
Full Name:
Gender: Female Male
Bilingual: Yes No
Address:
City/State/Zip:
Home phone:
Work phone:
Cell phone:
I was a pilgrim/butterfly on: Number of Walk/Chrysalis


Church/Forth Day Group Information:
Do you attend Church regularly: Yes No
Church Home:
Church Denomination:
Address:
City/State/Zip:
Church phone:
Pastor:
Are you active in your Local FDG Emmaus Gatherings? Yes No
How many Gatherings have you attended in the last year?
How many Candle Light Services have you attended in the last year?
Are you active in a weekly Reunion Group? Yes No
Reunion Group Name:
Date and Time of Meetings:
Please list your leadership qualities:


Prior Walk Information:
The Team Selection Committee is charged with maintaining a balance of experience on each Emmaus/Chrysalis Team. Please fill out as completely as possible.
Emmaus Chrysalis Kairos        #
Date Lay Director
Talk Given
Outside Team Music Asst TL Table Leader Asst. Lay Director
Lay Director
Emmaus Chrysalis Kairos        #
Date Lay Director
Talk Given
Outside Team Music Asst TL Table Leader Asst. Lay Director
Lay Director
Emmaus Chrysalis Kairos        #
Date Lay Director
Talk Given
Outside Team Music Asst TL Table Leader Asst. Lay Director
Lay Director
Emmaus Chrysalis Kairos        #
Date Lay Director
Talk Given
Outside Team Music Asst TL Table Leader Asst. Lay Director
Lay Director
Emmaus Chrysalis Kairos        #
Date Lay Director
Talk Given
Outside Team Music Asst TL Table Leader Asst. Lay Director
Lay Director
Emmaus Chrysalis Kairos        #
Date Lay Director
Talk Given
Outside Team Music Asst TL Table Leader Asst. Lay Director
Lay Director


References:
Reference 1
Name:
Phone:
Email:

Reference 2
Name:
Phone:
Email:

Reference 3
Name:
Phone:
Email:

If accepted to serve as a Walk/Flight/Journey Lay Director, I commit to follow the Upper Room module and to abide by the policies and procedure set forth by the Greater SWT Emmaus/Chrysalis Community Board & Hays Praise Board.

Signed:     Date: