Project Timothy Midwest Application First Year Application Midwest First Year Application Midwest Name: Address: City: State: Zip: Email Address: Cell Church Name: Senior Pastor's Name: Youth Pastors/Workers name: Youth Pastor's Email: Are you currently a leader at your youth group? Yes No If yes, what do you do? To attend Project Timothy, you need to commit to serving at your Youth Group in some capacity for the next year. Do you commit to doing this? Yes No Do you commit to paying the $250 fee if you are accepted? Yes No Are you vegan or vegetarian? Yes No PLEASE list any food allergies What is your T Shirt Size XS S M L XL XXL Have you ever been convicted of a crime? Yes No If yes, please explain Have you ever been convicted or accused of child abuse/sexual abuse or been involved in any activities related to molesting/abusing a child or a youth? Yes No If yes, please explain: Type your name below if all of the above information is complete and true If you are human, leave this field blank.