CYIA Application 2025

CYIA Summer Missionary Application

Christian Youth in Action North Carolina 2025
Please read the following document carefully. This includes important instructions, information, and requirements for each Summer Missionary. Download and/or print this document for your reference throughout the summer. If you have difficulties accessing this file, please contact Hope Malvitch at hope@cefwesternpiedmont.com to have the file below emailed to you.
General Information
Name*

First NameLast Name
Preferred Nickname
*if you do not go by your first name
Sex*

MaleFemale
Date of Birth*

MonthDayYear
Email*
example@example.com
Phone*
Please enter a valid phone number.
T-Shirt Size*
Allergies
medications, foods, etc.
CEF Chapter
*if known
What county in NC do you live in?*
This helps us determine your chapter
How will you be serving/training?*

JuniorSeniorJr InternSr InternStaffChaperoneStaff ChildOther
Emergency Contact*

First NameLast Name
Relationship*
Emergency Contact Phone*
Please enter a valid phone number.
Required Forms

There are two (2) new forms that must be ﬁlled out and signed by the parents/Guardian of the CYIA personnel. These are the Medical and Liability Release Form and Parental Activity Permission Form (attached below). Both forms must be completely ﬁlled out and must be signed by the parents or guardian.

Signature on the Medical and Liability Release Form must be on the same piece of paper (back of ﬁrst page), it cannot be on two separate pages. If you are unable to print on both sides of one paper, please request this form from your local CEF chapter director.

The original signed forms must be turned in when arriving at Camp Good News for training week during the check in process. Without these forms, CYIA'ers cannot be allowed to participate in the CYIA training. Please turn these forms in to your local CEF office prior to training week.

These forms will be returned to the chapter after CYIA training to be used during the chapter’s summer mission program.

Also included are the Background Check Release Authorization form and the CEF of NC Servants Contract.
Download and print this document front and back to fill out in it's entirety and turn in to your local CEF office. If you have difficulties accessing this file, please contact Hope Malvitch at hope@cefwesternpiedmont.com to have the file emailed to you.
Items under the "New Students" section are optional for returning CYIA students

If you are a new CYIA student, please click on the "New Students" drop down and complete the entire form

New Students
Spiritual Biographical Sketch

Describe your Christian experience including each of the following: your testimony (how you became a Christian); approximate date of your conversion; scriptural references for the basis of your salvation; your spiritual growth; your practices of prayer, Bible study, church attendance; how you serve in your Church or community; your convictions regarding alcohol, tobacco, and drugs; and your purpose for applying for Summer Missions.
Spiritual Biographical Sketch
Your answer is not limited by the space provided.
If you prefer to write your sketch in a separate document, you may upload it here.
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Training and Experience
Describe any training you have received from CEF
Describe any experience you have had working with children
Have you been used to lead a child to Christ?

YesNo
If so, please describe
Have you applied to any other summer job, mission trips, church activities or commitments this summer?

YesNo
If so, please describe
Do you have a valid driver's license?

YesNo
If yes, are you willing to drive a team of students to designated 5-Day Clubs throughout the summer?

YesNo
References

Your local CEF office needs to receive three reference forms before the applicant can be approved. Please send these forms with instructions to (1) your Pastor; (2) a Church Leader; and (3) a mature adult for them to fill out and submit directly to your local CEF office.

These can be submitted via mail or email. Below you will find the reference form in two formats, one is digitally fillable that you can send via email and the other is formatted for printing and mailing.

Before you send these forms to your references, please fill out the applicant's name at the top of the first page and provide the email or physical address for your local CEF office at the bottom of the second page.
Email Reference Forms
Mail Reference Forms

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CYIA Summer Missionary Application