To apply for a position on the Campus Life Tour, please complete the following form. If anything does not apply, enter "N/A".

Applicant Information
Name
Email Address
Current Home Address
City
State
Zip
Home Phone
Mobile Phone
Date of Birth
Position for which you are applying (all positions listed may not be available at this time)
If accepted, on what date
can you join the Tour?
Have you ever been convicted
of a criminal offense
(felony or misdemeanor)?
If "Yes", please describe the crime - state nature of the crime(s),
when and where convicted and
disposition of the offense
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:
Email:
References
Personal Reference (friend, family member, mentor, etc.):
Phone Number:
Email:
How do you know this person?
Professional Reference (employer, teacher, etc.):
Phone Number:
Email:
How do you know this person?
Education, Training and Experience
High School
School name
Number of years completed
Did you graduate?
Degree/diploma earned
College/University
School name(s)
Number of years completed
Did you graduate?
Degree/diploma earned
Vocational or other education
School name
Number of years completed
Did you graduate?
Degree/diploma earned
Do you have a driver's license?
Driver's license number
State of issue
Expiration Date
Have you had any accidents during the past three years?
If so, how many?
Have you had any moving violations during the past three years?
If so, how many?
Have you had any experience
driving a 15 passenger van
or other large vehicle?
Pro-life Experience
How did you hear about Survivors?
If you are a member of a pro-life group in your area, please complete the following:
Name of group
Contact person
Phone number
Group website
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
If you have not done so, we suggest that you read through the Survivors website.
Are you in agreement with the Survivors mission statement
(Why the Survivors Exist)
and statement of beliefs
(What the Survivors Believe)?
Summarize any additional experience, training, qualifications, or skills which you feel would help qualify you for the position.