Before You Begin
This leadership application is only for current residential students at Liberty University.

If you are a high school student or not a residential student, please click the "Apply" link above.

This application has 5 short sections and 1 long section. The application must be completed in one sitting; it cannot be saved. The application should take 15-20 minutes to complete.

Sections:

• Staff
• Personal Information
• Church
• References
• Background Information
• Writing

References:
You will need 3 references: A pastor, youth pastor, or youth worker from your home church who knows you closely and 2 adults (unrelated to you) who know you closely.
Please take the time to get their name and phone number ready before continuing with this application.

For which staff positions are you applying? (students may apply for any staff position to earn funds for their mission trip)

For Missionary Mentors, please list your trip preferences:

In what areas can you help?

Please list your level of experience in the areas you chose:

Are you interested in any of these?

Name:

LU Email:

Cell Phone:

LU Student ID:

Birth Date:

Year at LU:

How Did You Hear About XI?

Major/Intended Major:

Home Church Name:

Other:

Church Reference:
(Pastor, Youth Pastor, or Youth Worker who knows you closely.)

Name:

Phone:

Relationship:

How Long Have They Known You?

Reference 1:
(Adult non-family member who knows you closely.)

Name:

Phone:

Relationship:

How Long Have They Known You?

Reference 2:
(Adult non-family member who knows you closely.)

Name:

Phone:

Relationship:

How Long Have They Known You?

Have you ever been convicted of or plead guilty to a crime?

If yes, please explain below:

Have you ever been accused, charged, or alleged to have committed, or have you ever committed any act of neglecting, abusing or molesting any child?

If yes, please explain below:

Have you ever been treated for a psychiatric disorder?

If yes, please explain below:

Is there any circumstance or pattern in your life that would make it inappropriate for you to serve with minors or would compromise the integrity of Xtreme Impact or Liberty University?

If yes, please explain below:

Have you ever been concerned that you may have an addiction to drugs, alcohol, pornography or any other addiction; or has anyone ever suggested that you may have a problem with any of the above?

If yes, have you received Christian counseling and/or do you attend a support group?

Have you ever voluntarily left or been asked to leave a role within an organization due to a concern regarding inappropriate conduct with minors or adults?

If yes, please explain below:

Why do you want to participate with Xtreme Impact?

Please share a brief summary of your testimony:

What are your spiritual gifts?

Where are your passions in ministry?

What are your strengths?

What are your weaknesses?

How do you plan to raise the funds for your mission trip?

What are your hours of availability? (for your interview and potential work hours)