Willing Servant Application Download Application Willing Servant Application Δ First Name(Required)Last Name(Required)Address(Required) Street Address Address Line 2 City State StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Birth Date(Required) MM slash DD slash YYYY Primary Phone(Required)Your Walk #(Required)Church(Required)Email(Required) Are you able to pay the willing servant fee (current fee is $175)?(Required) Yes No Are you able to attend the team meetings (four scheduled team meetings prior to each walk)?(Required) Yes No Are you a member of the clergy?(Required) Yes No Any food allergies?(Required) Yes No List any food allergies or restrictions:Any health issues that may interfere with your Emmaus duties?(Required) Yes No List any physical limitations you may have:If you have served in any of the following areas. Please indicate the number of times in each capacity:Asst. Lay DirectorTable LeaderAsst. Table LeaderMusic HeadMusic TeamMusic TechSecret Angel HeadSecret Angel TeamKitchen HeadKitchen TeamAgape HeadAgape TeamWorship HeadWorship TeamPlease check the area(s) / team(s) you would like to serve on for the upcoming walks:Would Like To Serve Assistant Lay Director Table Leader Asst Table Leader Kitchen Head Kitchen Team Secret Angel Head Secret Angel Team Would Like To Serve (continued) Music Head Music Team Music Tech Agape Head Agape Team Worship Head Worship Team I would like to serve on:(Required) Men's Walk Ladies Walk Either Walk