Mail to IMPACT 7806 Chadwick , Prairie Village, KS 66208

All Advancers are encouraged to fill out this application to work IMPACT. There are no prerequisites for any team. You may work on any team, or even give a talk your first time working. I have listed the talks below. If you would like to give a talk, please specify which one and tell why.

I look forward to working with all of you. I know you won’t all be able to make this next IMPACT, but know that you are in my prayers as you seek to Advance Christ.

Name_________________________ Phone___________________________________

Address_________________________________City__________ST______Zip_______

School (if attending)_________________________________Email_________________

(Rank which team you would like to work in order of preference)

_______Agape (sorts agape notes and prays, prays, prays!)

_______Samaritan (banner, helps in kitchen, and cleaning, party or other special event)

Conference : _____Silent family leader ________Shepherd (gopher) ______Talk

Tell why you would like to give the talk you indicated.

Describe your current personal relationship with Jesus Christ. (be honest, it doesn’t determine your team just helps me understand your heart and pray about where you would best grow while working IMPACT.)