North Indiana Emmaus Community

Community

Emmaus

Chrysalis

Today is Wednesday, May 14, 2008

Laity YES! Application Form
for Emmaus/Chrysalis Teams
(NOTE: Clergy should go to this form to say YES!)

* indicates a required field

Name
* First Name
* Last Name
Address
* Street
* City
* State
* Zip
* County
Email Address
* Primary
Alternate
Phone
* Home Phone
Work Phone
Cell Phone
Date of Birth
* Date of Birth	(xxxx)
Church
* Name of Church You Attend
Walk/Flight (Must be valid.)
* Month/Year of Original Walk/Flight	(xxxx)
* Number of Original Walk/Flight
Fourth Days
* Are you currently attending Reunion Group?	Yes No
* Name of Reunion Group
* Are you currently attending Gatherings/Hoots?	Yes No
Previous Teams Please enter the Walk # or Flight # of positions served. (If you are uncertain about the Walk or Flight #, you may find the list of former lay directors helpful. If you served in a different community than NIEC, please specify what Community.)
Lay Director
Assistant Lay Director
Spiritual Director
Assistant Spiritual Director
Table Leader
Assistant Table Leader
Head BTS (Behind the Scenes)
BTS (Behind the Scenes)
Head Kitchen
Kitchen
Musician
If Musician, What Type?
Big House (flights only)
Talks Given
Other 72-Hour Weekend
IMPORTANT NOTE: If you attended or served on a Walk or Flight in a Community other than the North Indiana Emmaus Community (NIEC), please provide the name and location of that community and explain.
Name and Location
Please Explain
Walk or Flight Preference
* Please indicate your preference for serving on a Walk or Flight.	Walk Flight No Preference
Additional Comments (optional)

IMPORTANT NOTE: If you desire to serve on North Indiana Emmaus Community Flights or Walks, you MUST also complete and return a printed copy of the screening form. If you do not do so, you will not be eligible to serve and will not be called. The screening application may be downloaded here, but the ORIGINAL WITH ORIGINAL SIGNATURE must be on file with North Indiana Emmaus Community. Fill it out and return it today! This online submission will not be complete without it.

Emmaus

•  About Emmaus  •
•  Walks  •
•  Gatherings  •
•  Emmaus Board  •

Community

•  NIEC Home  •  Prayer Concerns  •
•  Crowing Creations  •  Reunions  •
•  Lay Directors  •  Clergy  •  Email List  •
•  Forms  •  Contact Us  •  Site Map  •

Chrysalis

•  About Chrysalis  •
•  Flights  •
•  Hoots  •
•  Chrysalis Board  •