Kairos Team #31 Membership Application

United States Penitentiary, Lompoc

May 28-31, 2010

Italic fields are optional; all others are required
First Name:
Last Name:
Address 1:
Address 2:
City:
State:
Zip:
Email:
Home Phone:
Cell Phone:
Business Phone:
Fax:
Date of Birth (MM/DD/YY):





Year of your walk:
Place:
# of street weekends worked:
Team positions you have held:
Kairos experience other than Lompoc (Location, Number and Position)
Kairos and "street" talks you have given:
Name of your Church:
Denomination:
Location:

I understand that by serving on a Kairos team I am obligated to attend not only the 3-1/2 day Weekend, but also the closely-following Instructional Reunion that is actually a component of the Weekend itself. In addition, I will make a strong effort to attend, for a period of one year, the monthly short (but very important!) reunions with residents who have made a Kairos weekend.

I will buy, read and follow the Kairos manual upon my acceptance as a member of the Kairos outside team.  I understand the importance of team formation and I will make a reasonable effort to attend the team building meetings preceding the weekend.

I will serve in whatever capacity appointed but I believe that my best capabilities are in the following area(s):

Table Leader- Speaker- Agape- Server- Music- Coordinator

Other: 

Comments: 

I will do my best to read and obey the prison regulations pertaining to visitors and will submit the required forms and take the yearly training.

(Non-electronic option): You may print this form, fill it out by hand, sign it, and send it via U.S. Mail to the Rector for the weekend:

Hank Bowis
811 Arbolado Road
Santa Barbara, CA 93103
Home: 805-962-2541 Cell: 301-440-5531 Fax: 805-962-0870

Note: The suggested donation for the weekend is is $80/person, plus another $10 to buy the new “Blue Book” weekend manual which replaces the old “Purple Book”.  Please make your check payable to "Golden State Kairos" and enclose it with your letter or bring it to the first meeting.