Application

Summer 2021

May 30- June 5, June 6-12, June 3-19, June 23-29, July 4-10, July 11-17,

July 18-24, July 25- 31 (circle one)

Name ______________________________________ Birthdate ____________

Address ____________________________________________________________________
City _________________________ State __________________ Zip __________
Phone (cell)______________________Email_____________________________________

Employer or School______________________________________________________
Church where you attend ____________________________________________________________________
Past Ministry Experience ____________________________________________________________________

Health Concerns or Disablities? (if so, please detail on the back)

Emergency Contact Name and phone ____________________________________________________________
Please attach (1) a brief recommendation letter from your pastor, church pastoral staff member or someone else who knows you well (2) $50 deposit to hold your place – applied to your total. (3) We also require applicants to send a background check before you come. Send payment to: GraceWorks, 4149 Checkmate Dr, Anchorage, AK 99508.

GraceWorks Alaska is a 501(c)(3)

tax-exempt organization.

All donations are tax deductible

as allowed by law.

GraceWorks Alaska
4149 Checkmate Dr.
Anchorage, AK 99508

907-440-4974
gograceworks@aol.com