LP 2020 PARTICIPANT Application

PARTICIPANT Application
Leadership Project 2020
The Leadership Project is designed to provide today’s college student with a leadership intensive situated in a life-giving environment. The combination of length, location, and leadership enables the Leaderhsip Project to meet the need for spiritual growth while also satisfying the desires for rest and enjoyment.
This application is for those desiring to participate in the 2020 Campus Outreach Leadership Project from May 19th - July 16th in Orlando, FL. If you have any questions, please contact your campus staff person. Thank you!
Important Dates:
Early Application Deadline - Friday, January 31, 2020
Early Acceptance Notification - Friday, February 14, 2020
Regular Application Deadline - Friday, March 27, 2020
Commitment Form Due - Friday, April 10, 2020
Part I: Contact Information
Full Name*
First NameLast Name
Gender*
FemaleMale
Birthdate*
MonthDayYear
E-mail
Please use preferred email to receive important LP updates!
Cell*
Area CodePhone Number
Ethnicity*
American Indian or Alaska NativeAsianBlack or African-AmericanHispanic or LatinoWhiteOther
Home Address*
Home Address Line 1
Home Address Line 2
Home CityHome State
Home Zip
Parents'/Guardians' Name(s)*
Parents'/Guardians' Email(s)*
School*
CampbellCharleston SouthernCollege of CharlestonDavidsonElonEast CarolinaThe CitadelUNC - CharlotteWingateOther
Year in School*
Expected Graduation*
MonthDayYear
Major*
T-Shirt Size*
Do you play an instrument?*
YesNo
If so, what instrument?
Are you a gifted singer?*
YesNo
Are you an NCAA athlete?*
YesNo
If so, what sport?
Part II: Project Information
Briefly describe your involvement with Campus Outreach.*
0/500
What do you believe is the purpose of the Leadership Project?*
0/500
What are some reasons you desire to be a part of the Leadership Project?*
0/500
Part III: Work Information
These questions are necessary for job placement at Universal Studios, Chickfila, etc...
Please check all that apply:
Taken addictive drugs (not prescribed to you) within the past yearBeen arrested with a misdemeanor or felony chargeReceived psychological treatment and/or counselingNone of these
Please explain any of the above answers as necessary:
Please explain any of the above answers as necessary:
Do you have any tattoos or brandings? (This will affect your job placement)
YesNo
If any part of the tattoo might be visible while wearing shorts and a t-shirt, please note below.
Are there any reasons why you will be unable to work the hours from 2-11pm during the work week and Saturdays? (ex: internships, summer classes, service projects, etc...)
Part IV: Personal Information
Given the highly relational nature of the Leaderhsip Project, the personal information below is important for discerning whether this is the best context for one's spiritual growth. This is private information and will only be viewed by project administrators. Indicating yes to any of the questions below will not disqualify you from participating in the Leaderhsip Project; however, we do ask that you be willing to discuss your answer with an appropriate CO staff person to know how we can best serve you.
Do you have a medical, physical, or psychological condition for which you are currently being treated? If yes, please explain.*
Do you consistently take any medications or prescriptions? If yes, please explain.*
Please check if you have ever:*
Suffered from anorexia nervosa/bulimiaBeen arrested on felony chargeTaken illegal drugsReceived psychological/psychiatric treatment and/or counselingHad suicidal thoughts in the past yearEngaged in any self-harming behaviors (cutting, burning, etc.) in the past yearNone of the above
Explanation
Reference #1
Reference 1 Name*
Reference 1 Phone*
Area CodePhone Number
Reference 1 Relationship*
i.e. Friend, Mentor, Employer, Family Member, etc.
Reference #2
If you attend a school where there is no formal CO ministry, please list a second reference.
Reference 2 Name
Reference 2 Phone
Area CodePhone Number
Reference 2 Relationship
i.e. Friend, Mentor, Employer, Family Member, etc.
If accepted, do you commit to attend support raising training and work towards securing 100% of your goal by the end of the LP?*
YesNo
Please upload a recent head shot of yourself.*
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LP App Fee (Debit/Credit)$15.00

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Your submission of this application affirms that you have, to the best of your knowledge, honestly and fully answered all questions. In the event the above information should be found to be untrue, it could result in forfeiting the opportunity to be a part of the Leadership Project.
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PARTICIPANT Application

Part I: Contact Information

Part II: Project Information

Part III: Work Information

Part IV: Personal Information