CYIA Interest Form

CYIA Interest Form

Thank you for your interest in serving as a Christian Youth in Action Missionary this summer! Please complete the following form and wait to be contacted by our office to schedule your interview.
Student's Name*

First NameLast Name
Birth Date*

MonthDayYear
Date
Church*
Please list the church you regularly attend
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
How did you hear about CYIA?
(Optional) example: presentation at my church
What is the best way for us to contact you?

TextCallEmailOther
Questions?

Contact our CYIA Ministry Coordinator, Cassidy Malvitch

Office: 704-871-2424 ext 304

Cell: 984-220-1648

Email: cassidy@cefwesternpiedmont.com
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