Thank you for serving in CCUC youth ministries. Please complete the following form so that we can keep in touch with you. All individuals serving in a CCUC youth ministry should complete this form. If any information changes, please use this form to provide updates.

Name

First Name

Last Name

Email Address

Phone Number

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Primary Fellowship

Are you the leader in charge of your fellowship group?

The following section should be completed only by fellowship lead counselor.

What grade levels does your fellowship serve?

(e.g. "3rd-6th grade," "high school," "college," etc.)

On what day and time does your fellowship regularly meet?

(e.g. "Friday nights, 7:30 PM - 9:30 PM")

If your fellowship has regular leadership meetings, when does the meeting occur?

(e.g. "First Friday of each month, after after fellowship")

Camps/Retreats

To help with budgeting for camps and retreats, please complete this section if your fellowship organizes any camps or retreats during the year. If some information (dates or location) regarding a retreat has not yet been finalized, please provide whatever information is available.

How many camps or retreats does your fellowship organize each year?

Camp/Retreat #1, Name, Dates & Location

(e.g. KS/YTF Winter Retreat, December 26-28, Lake Geneva Youth Camp, Wisconsin)

Camp/Retreat #2, Name, Dates & Location

(e.g. KS/YTF Winter Retreat, December 26-28, Lake Geneva Youth Camp, Wisconsin)

Camp/Retreat #3, Name, Dates & Location

(e.g. KS/YTF Winter Retreat, December 26-28, Lake Geneva Youth Camp, Wisconsin)