Chrysalis Team Application – Brazos Valley Emmaus Community

BRAZOS VALLEY EMMAUS COMMUNITY CHRYSALIS TEAM APPLICATION
Complete this form to be considered as a team member for one or more of the upcoming flights.
Today's Date

MonthDayYear
Date
Name
Email
example@example.com
Phone
Format: (000) 000-0000.
Date of Birth

MonthDayYear
Date
Gender
Church Affiliation
Church (City, State)
Occupation
Are you a Clergy?
Walk or Flight Attended / Reunion Group
Community Name
Flight-Walk #
Reunion Group Name
Previous Team Service History
List most recent team service first; date of service, position, talks given, etc.
Experience working with youth?
If yes, please describe
How are you willing to serve? (Please select all that apply):
On which flight do you want to serve?
Emergency Contact Name
Emergency Contact Phone
Please enter a valid phone number.Format: (000) 000-0000.
Additional Information: Use the field below to share additional information, as necessary. For example: Allergies (food, medications, pets), Special Diet, Physical Limitations, etc.
Additional Information
This form can be completed online and automatically sent to the Team Selection Committee by choosing SEND, or printed and mailed to the address below.

Team Selection
Brazos Valley Emmaus Community
PO Box 10491
College Station, TX 77842
Should be Empty:

BRAZOS VALLEY EMMAUS COMMUNITY CHRYSALIS TEAM APPLICATION