Briarlake Church Mission Trip Application

____ South Africa         ____India        _____ Mexico  _____SC             _____Other:

 

Please complete this form and return it by email to Terry Waterman at t-waterman@briarlakechurch.org, or bring a copy to the church office.

Personal Contact Information//

Full Name (as it appears on DL and Passport): ______________________________________

________________________________________  Birth Date___________________________

Email_______________________________________________________________________

Cell___________________________ Home________________________________________

Address_____________________________________________________________________

City__________________________        State_____             Zip________________________________

Passport #___________________________________________________________________

Passport Expiration Date________________________________________________________

 

Emergency Contact Information//

Name of person to contact______________________________________________________

Relationship_________________________________________________________________

Cell/Home#__________________________________________________________________

Health Insurance Company______________________________________________________

Policy and Group #____________________________________________________________

Primary Policy Holder__________________________________________________________

Allergies, Diet, Mental or Physical Health Concerns ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Ministry Information//

Briefly share your testimony (how you came to a relationship with Jesus Christ) and describe your relationship with God at the present time.

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Have you ever been on a mission trip? ________ If so, where and when? ___________________________________________________________________________

Describe the trip and your experience: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Please provide the name and contact info of someone that was on that mission trip with you to use as a reference? ___________________________________________________________________________

Please describe other ministry experiences you have had or ways you have served in the church (include approximate dates/years): ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

What words best describe you?

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________

What would you say are your Strengths? Weaknesses?

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Do you have any experience, talents, skills, or passions that may be beneficial on this trip/team? ________________________________________________________________________________________________________________________________________________________

Why do you want to be part of this mission team? ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

*Please read and sign the Team Member Covenant included with this application.

 

 Team Member Covenant

Thank you for completing and submitting this application! Completion of this application does not guarantee your placement on a team. You will be contacted regarding a possible interview and notified as to your status on the team. Please contact Terry Waterman (t-waterman@briarlakechurch.org) or Tim Underwood (t-underwood@briarlakechurch.org) if you have any questions.

Signature:____________________________________________________ Date:___________________

Print Name: ______________________________________  Mission Trip:________________________

Parent Signature (if under age 18):________________________________________________________