Winter Application

Personal Information

School Information

About You

Are you a Seventh-day Adventist?

Health Information

Are you taking any medications?
Medicine Allergies?
Food Allergies?
Are you covered under a health insurance plan?
I understand that basic medical coverage is required to participate in this program. It can be made available at a minimal per week charge. (for more information contact your canvassing leader)

Parent/Guardian Information


Enter the email addresses for two references. They will be sent a form to fill out. Your application will not be processed until we receive responses from both references, so you may want to check that they have received and completed the form. References must be a teacher, pastor, or work supervisor. No relatives.

Parent/Guardian Agreement (if under 18)

I hereby agree to give permission for my son/daughter to canvass this winter.
IMPORTANT: In case of an emergency or illness, I hereby give my permission to the physician selected by MagaMinistry directors to hospitalize, secure proper treatment, and to order injection, anesthesia, or surgery for my child. I realize I am responsible for payment of illness. Accidents, only while working, are covered by Worker's Compensation.
I agree to a background check.

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