Christian Youth in Action

Christian Youth in Action 2025 Wayne County Application
Deadline for CYIA Application Submissions

New CYIA Application: April 16, 2025 Past Summer Missionaries: March 19, 2025
Name

First NameLast Name
Date of birth:

MonthDayYear
Date
Students Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Students E-mail
Students Phone Number
Please enter a valid phone number.
Parent/Guardian Name

First NameLast Name
Relationship:
Parent/Guardian Address (Information needed if different than above)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parents Phone Number
Please enter a valid phone number.
Parents E-mail

Personal Testimony
New CYIA Candidates:

Please provide a written personal testimony in which you tell 1) when and where you received Jesus as your personal Savior and 2) how you know Jesus has saved you. You may use scripture to support your testimony.

Past Summer Missionaries:

Please share how the Lord has been working in your life over this past year, or share any ministry experiences you had sharing the gospel message this Fall or Winter.
Please Type In Your Testimony Below

Acknowledgement Statement:

I understand that the completion of CYIA Training does not guarantee that I will be accepted for service this summer. I understand that my attitude toward CYIA staff and fellow students does matter. I understand that while am at the Wayne County Chapter CYIA Training School, Pre and Post Training for Christian Youth In Action I am under the authority of the Wayne County Chapter CYIA Coordinators and all the staff. I understand that I am to follow the rules and guidelines that are outlined in the CYIA Student Guide.
Students Signature:

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Photograph Release

I give absolute right and permission to use my photograph(s), likeness or image(s) in a publication, electronic media (e.g., video, Internet, CD), or other forms of promotional materials for Child Evangelism Fellowship®. No payment will be made for the use of images taken or submitted by you. I release CEF®, their offices, employees, agents, designers, and the photographer from liability for any violation of any personal or proprietary right I may have in connection with such use.
I hereby state I haveread carefully and understand the foregoing and know the contents thereof, andI state my agreement with these legally binding agreements as my own free act.
Student Signature

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Date

MonthDayYear
Date
Parent/Guardian Signature

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Date

MonthDayYear
Date
A parent or guardian must also sign with and for a minor (under age 18).
Should be Empty:

Christian Youth in Action 2025 Wayne County Application

Deadline for CYIA Application Submissions

Personal Testimony

CYIA Levels for the CEF of Michigan, Inc. Wayne County Chapter

Level 1:

Level 2:

Acknowledgement Statement:

Photograph Release