2012 Presbyterian Youth Triennium

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1 2012 Presbyterian Youth Triennium What? The Presbyterian Youth Triennium is a gathering of over 6,000 youth and adults from the Presbyterian Church (USA) and the Cumberland Presbyterian Church in America at Purdue University in West Lafayette, Indiana. This year s theme is I Am. Who? Peace River Presbytery Youth (entering 9 th grade through 2013 graduated seniors, enthusiastic adult leaders (must be at least 22) and college work crew members. So there is a fair representation, we will initially take 2-3 youth from each church. There must be one adult for every 9 students of the same gender. We are seeking youth and adult chaperones who: Have shown a commitment to their faith, Are active participants in their congregations, Can live in a covenant community and Have exhibited leadership skills. When? July 16-20, 2013 Cost? The cost for the conference is $469 plus air travel, meals on travel days, and spending money. The Presbytery will assist with some costs. A $50 nonrefundable deposit is due with your application no later than Friday, January 19, 2013 (This will be returned/refunded if for some reason your application is not accepted). Typically, the cost of the event has been split three ways between the individual, church, and Presbytery. We will travel by air to Indianapolis, then by bus to Purdue University. Application Deadline: Please submit your application and Questionnaire no later than Friday, January 19, Applications may be sent electronically to or by mail to: Jimmy Steele, Chapel by the Sea Presbyterian, PO Box 2997 Fort Myers Beach, FL Phone: , ext. 15

2 Application for 2013 Presbyterian Youth Triennium Peace River Presbytery Delegation The Peace River Presbytery Delegation will be composed of youth and adults who are members and/or regular participants in the lives of congregations in Peace River Presbytery. Applications and Reference forms must be received no later than January 19th. Members of the Peace River Presbytery Delegation requirements / expectations: Be a member or active participant in the life of a Peace River Presbytery congregation Entering 9 th grade through 2013 graduating seniors Will travel to and from Triennium with the delegation Will return all forms and payments on time Will attend pre and post Triennium delegation event(s) Will abide by the Triennium Community Guidelines and Delegation Covenant For more information, contact Jimmy Steele, at or ext. 15 An online application can be found by visiting Please print 2013 Presbyterian Youth Triennium Application If selected, a Triennium registration form will need to be completed Name (Last) (First) (M.I.) Address City State Zip Home Phone Cell Phone / / Date of Birth M F Gender Current Grade, if youth Church Name If selected, I agree to observe all rules & participate fully in the Triennium. Signature of applicant Date: As parents/guardians, I/we understand that this event includes travel by air and bus to West Lafayette, IN, and that adults approved with background checks by the Presbytery will be supervising my child. Parent/guardian name printed Parent/guardian signature Date

3 Personal Questions: 2013 Peace River Presbytery Triennium Youth Delegation Questionnaire Form Please complete this form and include it with your application. Name: Favorite Color: Favorite Sport: Favorite Candy: Nicknames: Favorite Food: Favorite Sports Team: Favorite subject in school: Hobbies/Interests: Triennium Questions: (Feel free to continue your answers on the back of this paper or another paper if needed) Please explain why you want to attend Triennium and what positive characteristics you would add to our delegation if you were selected: Please describe your involvement in your congregation, school, and community: Please explain how you would share your Triennium experience with your home congregation and other congregations in the Presbytery:

4 2013 Peace River Presbytery Triennium ADULT CHAPERONE Delegation Questionnaire Form Please print neatly or type your answers and include it with your application. *All adults selected to chaperone will need to complete a background check* Personal Questions: Name: Favorite Color: Favorite Sport: Favorite Candy: Nicknames: Favorite Food: Favorite Sports Team: Favorite subject in school: Hobbies/Interests: Triennium Questions: (Feel free to continue your answers on the back of this paper or another paper if needed) Please explain why you want to attend Triennium and what positive characteristics you would add to our delegation if you were selected: Please describe your experience(s) with chaperoning young people in your congregation, schools, and community: Please explain how you would share your Triennium experience with your home congregation and other congregations in the Presbytery:

5 Congregation Endorsement and Reference Form: To be completed by the church and mailed separate from the applicant questionnaire Please complete this form no later than January 19 th and to Jimmy Steele: or send it in the mail to: Chapel by the Sea Presbyterian Attn: Jimmy Steele PO Box 2997 Fort Myers Beach, FL The congregation of Presbyterian Church in, Florida has endorsed as an applicant for the Peace River Presbytery Delegation The following questions should be answered by a staff or session member from the church who BEST knows the applicant. Please complete the questions and mail this form to the registrar. Please describe the strengths and positive attributes of the applicant: Please describe any weaknesses or negative attributes you feel the applicant may have: How long have you known the applicant/how long has the candidate been affiliated with your congregation? Reference filled out by: Job Title: Signature of Clerk of Session/Pastor/Church Educator/Youth Director: Date: