Print and complete this form and mail to:
Application for Emmaus Walk ______
Application for Chrysalis Weekend ______
Application for Emmaus Walk and Chrysalis Weekend ______
Submission Date:_____________
NAME _________________________PHONE (____)_______________
ADDRESS ________________________________________________
CITY, STATE, ZIP________________________________________
YEAR OF MY PILGRIM WALK OR FLIGHT _________ WALK/FLIGHT NO. ________ EMMAUS COMMUNITY _________________
(Please precede Walk No. with W, and Chrysalis Flight No. with C)
I'VE WORKED ______ WALKS AND ______ CHRYSALIS FLIGHTS SINCE THEN.
ARE YOU WILLING TO SERVE IN ANY CAPACITY, (INCLUDING AGAPE TEAM)? PLEASE ANSWER YES/NO __________
I AM ACTIVE IN THIS CHURCH OR GROUP: __________________
I AM ACTIVE IN THIS REUNION GROUP: ____________________
I AM ACTIVE IN THIS EMMAUS COMMUNITY:__________________
(The last 3 questions are the criteria specified by The Upper Room, the Walk to Emmaus parent body.)