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Personal Information

First Name: Last Name: Middle Name:
Address:
City: State: Zip:
Country: Phone #:
Alt. Phone #: Email:
Birthdate: / / Date of Baptism: / /
Gender:  Male    Female

Parent/Guardian Information

Parent/Guardian:
Address:
City: State: Zip:
Country: Phone #:
Alt. Phone #: Email:

Pastor/Lay Leader and Youth Worker

Pastor/Lay Leader: Phone:
Youth Worker: Phone:

Personal & Spiritual Background

1. Have you asked for forgiveness of your wrongs and received Jesus Christ as your Savior and Master?      Yes    No   

2. Are you a member of the Church of God 7th Day?      Yes    No   
If not, what church are you a member of:   

3.Briefly explain your history of church involvement:
4.Briefly explain what previous experience you have had in areas of Christian and/or community service:
5.What talents/abilities has God given you that you feel you could use for ministry?:
6.How do you expect the LITES program to assist you in your spiritual walk?:
7.Do you feel you have a heart for service? Explain:
8.Do you have a hunger for God? Explain:
9.Are you willing to lay down your sense of calling and obvious talents/gifts for a season to concentrate on spiritual character development? Explain:
10.Are you willing to set aside any involvement in and/or the pursuit of romantic relationships during LITES?:
11.What are your personal guidelines regarding music, clothing, entertainment, drugs (incl. alcohol and tobacco), and sexual activity? Explain:

Educational & Employment Background

1. What is the highest level of education you have completed?    

2. If you are currently enrolled in school, what school do you attend:   

3.Give a brief summary of the jobs you have held (incl. volunteer work):
4.What are your current educational/vocational goals?:

Family Background

1.Briefly describe your home life (interpersonal relationships, family discipline, feelings towards authority, etc.):
2.Describe your religious upbringing/background:
3. To what extent are you financially dependent on your parents (0% - 100%)?    %
If 0%, how long have you been financially independent?   

4. Are you currently living with your parents?      Yes    No   

5. How supportive are your parents of your interest in LITES?
(1=Not Supportive, 9=Supportive)
1 2 3 4 5 6 7 8 9

Health

1. How well do you handle stress? (1=Not Well, 9=Well)
1 2 3 4 5 6 7 8 9

2. Do you have any allergies?
 Yes    No    If yes, what and how are they treated?


3. Do you have any physical limitations or disabilities that should be taken into account?
 Yes    No    If yes, what?


4. Do you have any history of serious illness (i.e. sleep disorders, eating disorders, etc.)?
 Yes    No    If yes, explain:


5. Do you suffer from motion sickness?
 Yes    No   

6. List all prescription or OTC drugs you take on a regular basis:


7. How well do you handle brief periods of little sleep? (1=Not Well, 9=Well)
1 2 3 4 5 6 7 8 9

8. How emotionally stable do you consider yourself? (1=Unstable, 9=Stable)
1 2 3 4 5 6 7 8 9

Autobiographical Sketch

Please give a brief autobiographical sketch, including your personal testimony of how you accepted Christ into your life and your current relationship with Him.

References

Please list below three references, according to the types indicated. Please have each of the references you list send letters of recommendation directly to the LITES office.
Type Name Title/Relationship to you Phone # Address
Pastor/Local Church Leader
Other (non-family) Church Member
Non-Church Member