Application Form

Please fill out the entire form below. Every field needs to be filled out or the form will not submit. If you are under 18 years of age, please have your parent or guardian fill out the Parental Consent Form found in the Downloads page (application will not be accepted without this).

Personal Information

Full Name:

Date of Birth:

Phone Number:

Do you have a valid U.S.
Social Security Card?

Home Address:

City, State, Zip:

Email:

Sex:

Marital Status:

How long have you been SDA?

Which school do you attend?

Which school do you plan to attend next school year?

Why do you want to join
Idaho Youth Rush?

What are your favorite hobbies?

What are your favorite
music groups?

REFERENCE – NON-RELATIVE WORK SUPERVISOR

Full Name:

Phone Number:

Address:

City, State, Zip:

REFERENCE - PASTOR/NON-RELATIVE ELDER

Full Name:

Phone Number:

Address:

City, State, Zip:


By checking this box you agree that all the preceding information is correct to the best of your knowledge.