Acteens Activators Application
To apply for Acteens Activators or Acteens Activators Abroad please complete all questions.
Acteens Leader Information
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Phone
*
-
Area Code
Phone Number
Email
Church Information
Church Name
*
Church Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Church Phone Number
*
-
Area Code
Phone Number
Church Email
Acteens Group Information
Select which type of trip you are applying for:
*
Acteens Activators
Acteens Activators Abroad
SIZE OF GROUP
How many girls are will be in your group?
*
How many adult leaders/chaperones will your group have?
*
PLACE, DATE, TYPE OF SERVICE
Place of service:
*
Date of missions trip:
*
Type of work preferred:
*
Activities for which your group can be prepared:
*
GROUP BACKGROUND
Have members of this group participated in summer missions projects?
*
Please Select
Yes
No
If yes, describe where, types of projects, number of participants.
Submit
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