APPLICATION PROCESS FOR MEMBERSHIP 2015-2016
If you are interested in applying to be a member in The Exodus Project please complete the following:

  • Complete the webform below or Click Here to Download and Complete the participant application and parent consent form.
  • Write and type an essay with the topic of “Why I Want to Join The Exodus Project”. Your essay should be at least 200 words.
  • Submit your application and essay in one of the following ways: MAIL: The Exodus Project, P.O. Box 202, Bentonville, AR 72712 SCAN/E-MAIL: info@exodusprojectms.com
  • Once we receive and review your application packet, we will contact you for admission to the program and/or to schedule an interview and orientation. If you are admitted to the program, you will be required to purchase two shirts to use as your uniform which total $25. Thank you for your interest in The Exodus Project!

Complete the Form Below

    General Information

  • Personal Interest

  • Information About Me

  • Parental Consent

  • I grant permission for my child to participate in The Exodus Project and all program activities. As a parent/guardian, I understand I will be responsible for ensuring my child attends meetings, mentee appointments, activities and community service projects. I understand The Exodus Project (nor its directors- Antonio & Coletta Patterson, board members, staff or volunteers) is not liable in the event of an accident during Project activities including transportation to activities. In the event of an accident, I will be notified and if emergency medical treatment is needed, I will be responsible for any costs associated with treatment or transportation home. The Exodus Project is not responsible for lost, stolen, or damaged personal items.

    I understand my child will be held according to the standards and expectations outlined in the handbook (you can download a copy from the website).

    I consent to allow my child to be photographed and video taped during activities, trips and meetings for public service announcements, media releases, website, and other promotional purposes.

    In the event my child does not submit progress reports and report cards as required by the handbook, I consent to allow Project Directors (Antonio & Coletta Patterson) to receive a copy of my child’s progress report and report card directly from the school.

    I understand The Exodus Project is a 501(c)(3) non-profit organization and participation is open to all students ages 12-18 regardless of race, ethnicity, or religious beliefs.
  • Emergency Contact

 

Verification