COTE Service Application

Name *

First Name Last Name

Cell Phone

Area Code Phone Number

Home Phone

Area Code Phone Number

E-mail *

Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Which walk would you like to work? *

Choose All That Apply: *

Male Female Lay Person New Clergy Clergy

Do you meet regularly in a Reunion Group?

Yes No

Reunion Location

Current Place of Worship:

I Attended: *

Emmaus Chrysalis Cursillo Kairos Via De Christo

I am applying for an opportunity to serve:

Emmaus Epiphany (youth prison ministry) Kairos (prison ministry)

I WILL COMMIT TO ATTENDING ALL TEAM MEETINGS, to be active in a reunion group, to be present for the entire three-day weekend including Closing, and to attend the Follow-Up Meeting. I also agree in a spirit of love and obedience, to follow the guidelines for team service as outlined in the team manual and as directed by the COT Emmaus Board through it's representative and the Lay Director of the Weekend. I understand that I am responsible to pay the $175.00 weekend fee by the final team meeting.

Note: To pay the application fee, please fill out the payment form here AFTER submitting this application.

Signature *

Date

Month Day Year