Youth and Young Adult Ministry - Diocese of Grand Island
 



1225 S. Poplar St, Suite 100
North Platte, NE 69103
Toll-Free: (800)252-9325
Phone: (308)532-2707
Fax: (308)532-3574
 
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*Applicants must be 2 years out of high school to apply for staff.

 

First Name: MI: Last Name:

Sex: Male Female            Date of Birth

Year of High School Graduation:             Age:

Home Address:

City: State: ZIP:

***The school information is for those potential staff members who may still be in college at the time staff applications are being accepted.  If this information does not apply to you, please insert NA into those blanks.

School Address:

City: State: ZIP:

Home Phone:            School Phone:  

E-mail:

Marital Status: Married Single

Occupation:

Do you play guitar?:

Do you play keyboard?:

Are you trained in First Aide?  Yes No

Are you trained in CPR? Yes No

Have you made Higher Ground? Yes No When:

Have you made Higher Ground II or III? Yes No When:

Have you worked HG, HG II or HGIII? Yes No When:

Parish:

Pastor's Name:

Pastor's Mailing Address
(Don't Know? Click Here!) :

City: State: ZIP:

Please choose a t-shirt size (cost is included in registration cost):


Choose one of the following programs: (required)

HIGHER GROUND
   
  Week 1: May 30-June 4, 2010 No more staff positions available on this week. If you would like to be placed on a waiting list, please contact us.
  Week 2: June 6-11, 2010 No more staff positions available on this week. If you would like to be placed on a waiting list, please contact us.
  Week 3: June 13-18, 2010 No more staff positions available on this week. If you would like to be placed on a waiting list, please contact us.

HIGHER GROUND II

    First Choice Second Choice
 

Week 1: May 30-June 4, 2010

  Week 2: June 6-11, 2010

HIGHER GROUND COLLEGE RETREAT

  May 24-29, 2010
       

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