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Luke 18 High School Leader Application 2017
Luke 18 is January 12-14, 2018.

Please fill out this application form and print page 2.Please read carefully as there are changes in the process to become a high school leader from previous years.

This is an application and not a guarantee to participate on the Luke 18 Leadership team as a high school leader (sophomores, juniors and seniors) or guardian (freshmen). Decisions will be based upon timely submission of the application, previous participation/behavior at retreats and response to essay questions.

Fill out the page you print (page 2) and submit with the $40 fee to the St. Clare Parish Office by November 8, 2017.
Address: 1411 Cross St., O'Fallon, IL 62269 Attn: Luke 18
Please make check payable to St. Clare Parish (Luke 18).
*Required

Please note: At the end of this online application form, you will need to print the last page and press the submit button in order for your application information to be recorded.

Student information
Parent and students should work together on this section to provide the correct information. Emergency contact numbers must be reachable 24/7.
Last name
Your answer
First name
Your answer
Student's email address
Your answer
Street address
Your answer
City
Your answer
Zip code
Your answer
Please list any medical conditions
Your answer
Please list any allergies
Your answer
Mother's first and last name
Your answer
Mother's phone number
xxx-xxx-xxxx
Your answer
Mother's email address
Your answer
Father's first and last name
Your answer
Father's phone number
xxx-xxx-xxxx
Your answer
Father's email address
Your answer
Emergency contact name
Parent or other
Your answer
Emergency contact primary phone number
xxx-xxx-xxx
Your answer
Emergency contact secondary phone number
xxx-xxx-xxxx
Your answer
Your parish
Mark only one oval
Student section
Students, please fill out this information.
Grade in high school
Student phone number
xxx-xxx-xxxx
Your answer
T-shirt size
Adult sizes
Gender
Where you feel you can help:
Select a talk topic
(Seniors only respond)
I agree to attend at least 1 planning meeting. (Planning meetings are Dec. 17 and Jan. 7.
Seniors also must attend a Nov. 26 meeting for seniors only.
Required
Seniors only: If asked to drive other students to/from sleep houses, could you do so?
If yes: How many can you drive (including yourself)?
Your answer
Parent volunteer section
Please consider offering to help make this weekend a big success
I would be happy to have a sleep group at my house
Mark only one oval
If a sleep house, list any types of pets in your home.
Your answer
I can provide transportation for a group from St. Clare School to a sleep house and back.
10:30 p.m. Friday and Saturday; 7:30 a.m. Saturday and Sunday
If providing transportation to/from a sleep house, please list the number of students you can transport
Your answer
I would be able to work a shift in the kitchen, if needed
Mark only one oval
I have completed the Belleville Diocese Child Protection certification and training
Mark only one oval
Press submit button after printing the second page
Your registration is not complete until you print the last page and press the submit button.
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