YEP 2019 Application
Hari Om! Below, you'll find the first step in applying to the Youth Empowerment program (YEP) of 2019. If you have any questions along the way, please email
Email address *
Name *
Sex *
Age *
Birth Date *
Address *
Email *
Phone Number *
Emergency Contact Information *
Type in as: Name, Phone Number
Do you have a connection with a particular Chinmaya Mission Center?
If so, please list which one.
Will you be participating in full time or part time seva after the YEP course? *
If unsure, this can be clarified during the interview process.
All YEP attendees are required to dedicate 1-2 months in service of a Balvihar/regional Chinmaya Mission camp during the summer after their YEP batch. Are you able to fulfill this requirement? *
Please attach a one page document explaining your interest in taking this course. In the same document, please list who or what most influenced you to apply to YEP 2019. Finally, include the contact information of three people that can be used as your personal references. *
Do you have any food or other allergies?
If so, please list all of them.
Do you have any other medical conditions that the camp organizers should know about?
This question is for the applicant's safety, so please list anything that you may think of, including mental health conditions.
Health Insurance Information
Please upload a picture of the front AND back of your health insurance card. This is required for the safety of all those who attend the course. We assure you that we will keep this information secure and private.
Do you play a musical instrument, sing, dance, or participate in any other artistic activities?
If so, tell us a little about what you do!
Are you an athlete?
If so, tell us a little about what you do!
Anything else you would like to inform the YEP organizers about?
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service