Online Team Application Form

Team member application

* Indicates required field

Name *

First

Last

Street Address *

City *

State *

ZIP *

Email *

May we use this e-mail address to send you "time critical information" from the Chrysalis Board of Directors? *

Date of Birth *

Gender *

Cell Phone Number *

Church Name *

When would you like to serve? *

Duty/Service Preference? *

Please keep in mind that there may be certain qualifications/past experience required to work certain work areas. If you need to view the qualifications, please click here. Please know that we want you to serve! If you are not qualified to serve the area you wish, apply for another position so you can get qualified! We want God to use you!

Will you give a talk? *

Special Talents or Limitations? *

Do you have any medical background? CPR certified or something similar? *

Name/Date & Location of the walk you attended *

Are you in a reunion group? *

Do you participate in Chrysalis/Walk to Emmaus gatherings/events? *

Past Chrysalis Team Experience *

Comments *

Electronic Signature (Please type your name) *

First

Last

Date *

Submit

If you are placed on a team, you will be contacted to complete a background check as required by the Upper Room covenants.
Also, Lay Directors are the responsible parties to notify you upon placement on a team. Please be patient. Team selection will begin in the fall.

...empowering leaders to be the hands and feet of Christ

Team member application