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SECTION 1: Session Selection
Please indicate your 1st and 2nd choice for the ChIP session you want to attend:
Session 1:
Session 2:
 
SECTION 2: Applicant Information
First Name:
Middle Name:
 Last Name:
Preferred Name:
 Birthdate: (m/d/y)
/ / 		Gender:
Email:
Address
Street:
City:
Province:
 Postal Code:
Phone:
-- Ex
Use Until: (m/d/y)
/ /
Parent/Guardian Information
(Required if applicant is under 18 at time of application)
First Name:
Last Name:
Phone:
-- Ex
Email:
SECTION 3: More Information
Please provide the following information. It is very important that you completely fill out all of the items that apply to you.
 
1. Please share your journey of faith. (Include such things as: salvation, significant events, how God is working in your life.)

 
2. Please describe why you would like to be part of the ChIP experience ?

 
3. What skills, experiences, abilities do you bring to a group ?

 
4. Please describe your involvement with your local church and/or other Christian ministries.

 
5. Please describe other activites/hobbies/community events you are active in and how you like to use your spare time. (What you do outside church and classes. Ex. Sports, Art, Community Theatre, Reading, etc.)

 
SECTION 4: Church Information
(Please give the information for the church you are most actively involved with and knows you the best. It is our aim to partner with churches to help in the discipling of all stepping stones participants.)
 
Church Name:
Denomination:
Street:
City:
Province:
Postal Code:
Phone:
-- Ex		 Fax:
-- Ex
Website: (if available)
Church Contact/Reference
First Name:
Last Name:
Position with church:
Street:
City:
Province:
Postal Code:
Phone:
-- Ex		 Email:
SECTION 5: References
Please provide the names, phone numbers and emails (if possible) of the references that will be filling out and returning the reference forms, including your church contact. (Reference forms available online at http://steppingstones.fairhavens.org/downloads.asp)

New applicants must provide three references. Returning staff must provide a church/ministry reference, and either work/adult friend reference. (See application kit for details.)
 
Work or School Reference
(your boss, volunteer work supervisor, teacher or priciple)
Name:
Phone:
-- Ex
Email:
 Relationship: (in what capacity do you know this person)
SECTION 6: Acknowledgements
To be considered for stepping stones, you must agree with the following statements
1. I have downloaded and read the 2008 ChIP application kit
2. I have read and agree to abide by the Fair Havens Ministries Code of Conduct if accepted (see application kit for code of conduct)
3. I have read and agree with the AGC Statement of Faith (see application kit for copy of statement of faith, or go to www.agcofcanada.com)
Signature
By checking this, I understand and agree to this application
Note: Guardian must sign if applicant is under 18 years of age
By checking this, I understand and agree to this application

Before you submit...
  • Check to make sure you have completed the application in full.
  • Remember to send the Reference Form to each of your references.
  • You may wish to print this application for your own reference.

 
We stronly suggest that you save the application before submitting. If you application goes through successfully, you will receive a confirmation email.