Youth - Leadership Team Application Applications due by 8pm Jan 17, 2010

Cell:     Email:

Male Female      7th Grade 8th Grade 9th Grade 10th Grade 11th Grade 12th Grade     School:    Birthday:

List Activities Involved In:

Baptized by emersion? Yes    No

Member of FBC? Yes    No

Please write 150 word essay telling us about yourself (that's only about half a page!):