IMPACT TEAM APPLICATION
For Tomorrow's Leaders Today
Full Name
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First Name
Last Name
Date of Birth
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Month
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Day
Year
Date
Age
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Social Security Number (Required for background check)
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Email Address
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example@example.com
Phone Number
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Please enter a valid phone number.
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
T-Shirt Size
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Unisex Adult Sizes
Social Media Profiles
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@username - Instagram/Facebook
How did you hear about TLT?
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Have you mentored with us or any other organizations before?
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Are you related to anyone attended TLT Conference? If Yes, please provide name and relationship.
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Current Employment?
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Where and how long have you worked there?
Education?
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Are you currently pursuing a degree? If so, what School & Major
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Please desribe what you hope to RECIEVE from the Impact Team experience.
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What do you PERSONALLY want to get out the TLT Experience.
In what ways would you make an impact in the lives of TLT Candidates?
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Please describe your top 3 strengths & 3 weaknesses.
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What negative behaviors have you successfully overcome and how?
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Select one or more of the following activities you enjoy and/or have experience in.
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Teacher, Mentor, Counselor, Small group leader
Sports & Fitness
Drama (Acting, theater production, dance, poetry, etc)
Music (singing, playing an instrument, writing songs)
Nature (Outdoor Activities)
When mentoring teens, what advice would you be passionate about imparting?
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What do you feel has uniquely prepared / qualifies you for this position.
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Describe your faith in God and how it is expressed in your daily life.
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Today's youth face many challenges. Our intent for IMPACT TEAM Members is to present fresh perspectives from faith-filled role models like you!
Please use the section below to elaborate on areas you have overcome and how that testimony can impact future generations...
Check all areas that apply
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Depression, anxiety, other mental illness
Self-Harm (cutting, eating disorder, etc)
Violence toward others (verbal or physical)
EQ challenges (unforgiveness, hatred, rebellion, judgement, self-loathing, other)
Entertainment addiction (screen time: gaming, social media, TV/videos, other)
Alcohol abuse
Smoking or vaping nicotine
Smoking or vaping marijuana
LGBTQ+ experimentation or lifestyle
Pornography
Promiscuity / pre-marital sex
Abortion
Out of the items checked above, describe how it has affected your life and how you have overcome it.
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Reference #1 Name
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First Name
Last Name
Reference #1 Phone Number
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Please enter a valid phone number.
Reference #2 Name
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First Name
Last Name
Reference #2 Phone Number
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Please enter a valid phone number.
Upload any of the following: Resume, Letters of Reference, and Profile Picture
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Please provide as much of the above materials as possible.
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Check the following requirements to agree to:
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Watch Director Video
PARTICIPATE in staff training day before iDENTIFY & debrief day after students leave
SHEPHERD my "iDENTIFY Peeps" at all times
SERVE fellow team members and TLT candidates
CHOOSE to be supportive, engaged and positive part of the team
MODEL serving leadership- quick to help, looking for a win-win
FOLLOW Dress For Success Code
Code of Conduct
SPEAK LIFE without cursing
ENGAGE in mentorship conversations and offer prayer when appropriate
NOTIFY Staff Director if my commitment to guidelines change
ARRIVE early to training and program sessions (early is considered on time!)
COMPLETE personal background check
WORK wholeheartedly as unto the Lord (Col 3:23) with an attitude that reflects Jesus(Phil 2:12-16)
FUNDRAISE with the IMPACT Team to cover expenses and fund students in need or byraising money.
Everything on this form is true, correct, and guaranteed completion.
Sign below to agree to the above statements.
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