THE CORE application

Basic Information
Name*
First Last
Date of Birth*
Date Format: MM slash DD slash YYYY
Age*
Email*
Cell Phone*
Home Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Preferred Social Media and Username

Father's Information
Name
First Last
Cell Phone
Email
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Name
First Last
Mother's Information
Cell Phone
Email
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Church Information
Youth Pastor's Name
First Last
Youth Pastor's Cell Phone
Youth Pastor's Email
Church Name
Denomination
Church Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Testimonial Video
Please paste your link below to your 2-4 minute video on your brief testimony and how God is moving in your school, church or city. If not applicable at the moment, please send your link to core@youthforthenations.com as soon as possible.
Video Link

Basic Information