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To apply for a position on the Campus Life Tour, please complete the following form. If anything does not apply, enter "N/A".
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| Applicant Information |
Name |
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Home Phone |
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Mobile Phone |
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Email Address |
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Current Home Address |
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City |
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State |
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Zip |
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Date of Birth |
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Position for which you are applying (all positions listed may not be available at this time) |
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If accepted, on what date can you join the Tour? |
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Have you ever been convicted of a criminal offense (felony or misdemeanor)? |
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If "Yes", please describe the crime - state nature of the crime(s), when and where convicted and disposition of the offense |
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| Education, Training and Experience |
High School |
School name |
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Number of years completed |
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Did you graduate? |
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Degree/diploma earned |
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College/University |
School name(s) |
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Number of years completed |
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Did you graduate? |
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Degree/diploma earned |
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Vocational or other education |
School name |
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Number of years completed |
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Did you graduate? |
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Degree/diploma earned |
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Do you have a driver's license? |
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Driver's license number |
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State of issue |
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Expiration Date |
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Have you had any accidents during the past three years? If so, how many? |
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Have you had any moving violations during the past three years? If so, how many? |
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Have you had any experience driving a 15 passenger van or other large vehicle? |
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| Pro-life Experience |
How did you hear about Survivors? |
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| If you are a member of a pro-life group in your area,
please complete the following: |
Name of group |
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Contact person |
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Phone number |
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Group website |
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| Briefly describe your level of involvement |
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| Briefly describe any other pro-life involvement or experiences |
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| Please explain why you feel your generation should be actively pro-life |
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| If you have not done so, we suggest that you read through the Survivors website.
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| Summarize any additional experience, training, qualifications, or skills which you feel would help qualify you for the position. |
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