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The Chozen Generation Individual Member Application
Church Affiliation
Login Name
Password
First Name
Last Name
Sex
Address
City State Zipcode
Mobile ( -
Email @
Your Shirt Size
SSN - -
Are You A Youth Leader?
I am available to
Have you ever been charged or convicted of any of the following offenses: Use or Distribution of illegal drugs, any violent crime, any crimes involving sexual harrassment or questionable or illegal activities involving youth?
If yes explain:
The adults listed have been authorized to by our congregation to function as adult leaders of our group. We authorize the Chozen Generation to conduct a reasonable background check