Application for Chrysalis Team Service

First name	Last name Initial
Address	Address
City	State Zip
I am a	Male Female

Home	Business Cell
E-Mail
Occupation	Employer
Your Church
Church Address
City	State Zip
Pastor Name	Phone
Your Church activities


Reunion Group Name Meets at

I attended	on (date)

Are you musically gifted? yes No What instruments do you play?

I have served as a member of the following team(s):

Team

Date

Place

Job

Talk

What are your special dietary / medical needs?

If accepted to serve on a Cross Bayou Community team, I commit to attending all the team formation meetings and to be present for the entire three-day weekend, including the closing. I also agree, in a spirit of love and obedience, to follow the guidelines for team service as outlined in the Team Manual, and as directed by the Cross Bayou Community Administrative Boad through its representatives and the Lay Director of the weekend. I understand that I will be responsible to papy the fees for the weekend.
(Scholoarships may be available) I wish to apply for a scholarship.

I have read and understand the conditions stated above Yes No Today's date

Return to: Mark Perkins - 401 Market St, Suite 900, Shreveport, LA 71101

Clicking this button will e-mail this application to the Team Selection Committee.