YWAM Staff Application

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Upon receipt of the completed application and references, Youth With A Mission Mendocino Coast at the Lord's Land will prayerfully consider the application and notify the applicant of their decision. At this time, we are not able to offer international visas. Some Canadians and Europeans have been able to stay for up to one year, but other nations are being denied extended B1/B2 visas.

Email *

Full Name *

Start Date *

YYYY

Duration of service committing to *

Phone Number *

Facebook Account Name

Current Address *

Sex *

Male

Female

Date of birth *

YYYY

Marital Status *

Single

Engaged

Married

Separated

Divorced

Required

Accompanying Family (Spouse/Children)

List full name, age, gender & education level of family members accompanying you (if applicable)

Emergency Contact:

Name *

Relationship to applicant *

Phone Number *

Address *

How long have you been a born again Christian? *

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