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Application to Join a Short Term Mission Team

Mission Team to: Honduras

Trip information

Depart(Required)

MM slash DD slash YYYY

Return(Required)

MM slash DD slash YYYY

Personal information

Your Name(Required)

First Middle Last

As it appears on your passport.

Your Address(Required)

Street Address City State ZIP Code

Contact Phone(Required)

Email(Required)

Employer/ Occupation

Position

Student

Yes

Date of Birth

MM slash DD slash YYYY

Marital status

Married

Single

Citizenship(Required)

United States

Other (enter country below)

Country of citizenship

Passport Number(Required)

Passport expiration date (required)(Required)

MM slash DD slash YYYY

T-Shirt Size (unisex)(Required)

Missions experience and skills

Previous experience in short-term missions?(Required)

Yes

Where

When

Particular area of ministry you wish to participate in

If you have skills in a particular area or would like to contribute efforts in an area such as “Education” or “Health/Medical”, please indicate here.

Languages Spoken

Language

Degree of fluency

Do you sing?(Required)

Yes

Describe your singing experience

Do you play any instruments?(Required)

Yes

What instruments do you play?

Drama experience?(Required)

Yes

Describe your drama experience

Faith experience

Are you a Christian?(Required)

Yes

How long have you been a Christian?

Where do you attend church?(Required)

Pastor(Required)

Would you be interested in leading a devotional while on your trip?(Required)

Yes

Health status

What is your general health?(Required)

Fair

Good

Very Good

Excellent

Do you have allergies or special medical considerations?

Yes

Describe you allergies or special medical considerations

Are there any health issues which could hinder you on a mission trip to a less developed country?(Required)

Yes

Describe any health issues

Emergency contact information

Name(Required)

First Last

Relationship to you?(Required)

Phone (Day)(Required)

Phone (Evening)(Required)

Signature

Participant Signature(Required)

Date(Required)

MM slash DD slash YYYY

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