Short Term Mission Team Application Mission Team to: Honduras Dates of Trip:Depart* MM slash DD slash YYYY Return* MM slash DD slash YYYY Your Name* First Middle Last As it appears on your passport.Date of Birth MM slash DD slash YYYY Your Address* Street Address City AlabamaAlaskaAmerican 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 State ZIP Code Home PhoneCell Phone*Email* Employer/ Occupation Position Student Yes No Previous experience in short-term missions?* Yes No Where When Marital Status Citizenship* United States T-Shirt Size* Passport Number* Expiration Date* MM slash DD slash YYYY Languages SpokenLanguageDegree of fluency Do you sing?* Yes No Do you play any instruments?* Yes No What instruments do you play? Drama experience?* Yes No Are you a Christian?* Yes No How long have you been a Christian? Where do you attend church?* Pastor* Would you be interested in leading a devotional while on your trip?* Yes No What is your general health?* Fair Good Very Good Excellent Any allergies or special medical considerations (No or Yes plus details)?* Are there any health issues which could hinder you on a mission trip to a less developed country (No or Yes plus details)?* In the event of an emergency, who should be notified?Name* First Last Relationship to you?* Phone (Day)*Phone (Evening)*Is there a particular area of ministry you wish to contribute to on this team?Participant Signature*Date* MM slash DD slash YYYY