CYIA Registration Form Combined 2024

CYIA Student Application Form

Please enter information carefully. NOTE: This application will take about one hour to complete.
Before filling out the application, please review the applicant requirements by clicking here.
Student Name

First NameMiddle NameLast Name
Birth Date

MonthDayYear
Gender
Grade in School
Are you....
This helps us to better know how to schedule interviews.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student E-mail
example@example.com
Parent E-mail
example@example.com
Your Mobile Number

Area CodePhone Number
Parent or Guardian's Name/s
Parent's Phone Number

Area CodePhone Number
Parent's Phone Number

Area CodePhone Number
What is your T-Shirt Size?
Name of Church
Name of Pastor and Youth Pastor
Please upload a recent picture of yourself (.jpeg)*

Browse Files

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Are you a New CYIA or Returning Student?

Reference: Your Pastor/Youth Pastor (Please include name, address, city, state, zip and phone number)
Reference: Youth Leader/Sunday School Teacher (Please include name, address, city, state, zip and phone number)
Reference: Adult who knows you well (i.e. teacher, mentor) (Please include name, address, city, state, zip and phone number)
Reference: Friend (Please include name, address, city, state, zip and phone number)

Questions Concerning Your Conversion and Christian Life
Tell about how you were saved - your testimony
Your Christian experiences (i.e. missions trips, camps, etc.)
A verse of Scripture and how it has impacted your Christian walk
Why are you interested in evangelizing children?
Why are you attending this Summer Missionary Training?
List any special trainings/abilities
What teaching experiences have you had? (i.e. Sunday School, AWANA, VBS etc.)
What leadership training have you had?
Any other information you would like us to know?

References

You will need to get two written references from those listed on page 1. Please print these forms and have them sent to your chapter staff member. Click here to print.

Are you planning on working as a paid employee?

Financial Policy for Christian Youth In Action®

1. Minimum Work Requirement- teens must work a minimum of two weeks after attending Christian Youth in Action training.

2.      Criteria to be a Paid Employee- teens must choose to work as volunteers or paid employees. Those who opt to be paid must meet the following criteria:

a.       Must be 14 years old (by federal law, teens under 14 cannot receive wages). Teens who turn 14 during the summer may be paid for clubs taught after their 14th birthday.

b.      Submit an Employment Application and completed forms (W-4, IA-W4 and I-9) to the CEF office by the time of CYIA.

c.       Raise enough support to adequately cover training fee and wages earned.

3.      Support Raising- all paid CYIA summer missionaries are required to raise support for the CYIA fund, compiling a list of at least 25 people to whom they will send support letters. CEF will format and print support letters for the teens using a CYIA support letter template which describes training and summer ministry. At CYIA pre-training, teens will have the opportunity to prepare and address their letters for distribution.

4.      CYIA Fund- all monies contributed on behalf of a summer missionary will be put into their CEF chapter CYIA fund. CEF will issue a tax-deductible receipt to all donors.

5.      Surplus Financial Gifts- if more support comes in for a teen than is needed to cover his/her summer ministry expenses, the surplus will be allocated to help defray the cost of the summer 5-Day Club® ministry. This will be stated on support-raising letters. Funds will not be designated for individuals and carried over to the next year.

6.      Timesheet & Salary- to receive pay, summer missionaries must submit 5-Day Club weekly report/timesheets indicating clubs taught. Checks will be issued once, at the end of the summer. Pay is determined by the salary schedule below.

Please note: Child Evangelism Fellowship makes every effort to utilize funds as designated; however, according to IRS guidelines all gifts must be under the direction and control of CEF to be used for charitable purpose of the ministry.

Salary Schedule

1st year teacher- $65 per club

2nd year teacher- $70 per club

3rd year teacher- $80 per club

4th year teacher (or 18 or older)- $90 per club

Note: clubs are scheduled to run for 1.5 hours each.
I have read the CYIA Financial Policy and agree to abide thereby.
Summer Missionary Signature:*
Parent's Signature: *

Are you over the age of 18?
If yes, you will need to fill out a confidential screening form by clicking here.
Please click here for the if you are over age 18 confidental screening form.

Thank you!
Thank you for submitting your application to CYIA! Once we have reviewed your applicationa and references, we will contact you for an interview.

If you have any questions, please contact director Shane Van Donselaar at 641-651-0332.
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CYIA Student Application Form

Questions Concerning Your Conversion and Christian Life

Thank you!