“Loving Jesus and Sharing His Love” Doulos/Staff Application 2017 Doulos Sessions June 11th – June 23rd Please Include a Picture of yourself June 25th - July 7th Please Call if you have any questions. July 8th – July 21 st Scan and e-mail or Mail to us. July 22-Aug 4th [email protected] Over 18? Doulos Staff Dates Available to Serve ___________ to ___________ Name: _________________________________________________ Male Female Address:________________________________________________________________ City/State/Zip: ___________________________ Home Phone: _____-______-_________ Email Address: _____________________________ Cell Phone: _____-______-_________ Date of Birth:_________ Age _____ Grade______ Have you participated in the Doulos Program or Summer Staff before? Yes No Dates:_____________________________ Check here to be placed on our mailing list Personal Info (Please Print) 1. Name of Church/Fellowship that you attend: __________________________________________________________________ 2. Pastor’s & Youth Pastor’s Names & Phone Numbers: __________________________________________________________________ 3. Personal Reference Name & Phone: __________________________________________________________________ 4. Write out your personal testimony. After we receive your application, we will contact you by phone. Please e-mail if you have any questions about the process. www.ydionline.org 117 Sparrow Lane, Head Waters, VA 24442 540-396-4823 Session Dates Summer 2017 Applicant Info (please print)