Survivors Campus Outreach Application

To apply for a position with Survivors Campus Outreach, please complete the following form. If anything does not apply, enter "N/A".

Applicant Information

Name

First Name

Last Name

Email Address

Current Home Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Birthday

Mobile Phone

(###)

###

####

Home Phone

(###)

###

####

Church Background

Do you attend church on a regular basis?

What is the name of your home church?

How long have you been a member of this church?

Please list a church contact

(Pastor, Youth Pastor, etc.)

Phone Number

(###)

###

####

References

Personal Reference

(Friend, Family Member, Mentor, etc)

First Name

Last Name

Phone Number

(###)

###

####

How do you know this person?

Education Training and Experience

High School

School Name

Did you graduate?

College or University

School Name(s)

Years completed?

Degree

List your degree and major

Vocational

or other education

School Name

Driving Information

Do you have a drivers license?

Pro-Life Experience

If you are a member of a pro-life group in your area, please complete the following:

Name of group

Contact Person

First Name

Last Name

Phone Number

(###)

###

####

Group website

http://

Briefly describe your level of involvement

Briefly describe any other pro-life involvement or experiences

Please explain why you feel your generation should be actively pro-life

Agreements and Closing thoughts

Are you in agreement with the Survivors Mission Statement and Statement of Beliefs?

Read the ABOUT US / WHO ARE THE SURVIVORS page

Summarize any additional qualifications that you feel would qualify you for the position

Survivors

Survivors is a Christian, pro-life activism organization dedicated to educating and activating high school and college age individuals.

If you were born after 1972, we challenge you to consider yourself a Survivor of the Abortion Holocaust. 1/3 of your generation has been killed by abortion in America!

The Survivors are taking an active stand on behalf of those who have already been lost, and for those who are scheduled to die through abortion. We are empowered by the truth, enabled by extensive training, and unafraid of condemning the death of innocents.

Campus Outreach Application

Survivors Campus Outreach Application

Survivors

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