CHAOS Small Group Leader Application

Please fill out this form to apply to become a CHAOS small group leader.

First Name

Last Name

Mobile Phone

Birthdate

/ /

Gender

Male Female

Address

Marital Status

Tell Us About Yourself!

I am...

(ex: Freshman at UNI studying biology/Parent of a junior high student/Working as a teller at Veridian/Retired man looking to invest in junior high students)

Please list any allergies (especially food) or chronic medical conditions.

Tell us a little about your faith journey.

What church do you currently attend?

What is exciting to you about being involved with Jr. High students at CHAOS?

T-Shirt Size

If you have a pal / friend / classmate / coworker that YOU think should help lead at CHAOS, please list their name, phone number and/or email.

Anything else that we should know about you or you want us to know?

Submit Application