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You can apply for California Youth Rush Here.

June 10-August 17, 2012

Youth Rush Application

Step 1 of 4

25%

First & Last Name*
FirstLast
Email*
Enter EmailConfirm Email
Address*
Street AddressCityStateZip Code
Home Phone
Cell Phone
Date of Birth*
MM
DD
YYYY
Marital Status*
Gender*

If hired, would you be able to provide evidence of authorization to work in the U.S.?*
Citizenship*
Section Break
School*
Grade
Which School will you attend next year?
How long have you been Adventist?*
Why do you desire to canvass?*

What are your hobbies?*
What type of music do you enjoy?*
Do you speak Spanish?*
How did you hear about Youth Rush?*
Would you be interested in SOULS WEST?*
For more information about SOULS WEST visit www.soulswest.org

Pastor's Name*
FirstLast
Pastor's Address
Street AddressCityStateZip Code
Pastor's Phone*
Non- Relative Name*
FirstLast
Non-Relative Address
Street AddressCityStateZip Code
Non-Relative Phone*
Father's Name*
FirstLast
Mother's Name*
FirstLast
Parent's Address
Street AddressCityStateZip Code
Parent's Phone*
Any Comments?
Phone
This field is for validation purposes and should be left unchanged.