Bishop 3C’s Initiative UMVIM Trip

CAMPHOR MISSION STATION  Liberia – West Africa        


___ February 15-March 3 2014 UMVIM Trip

Cost $ 3000 per person




Age _______ Birth date __________________________   Gender:        Male         Female


Phone (H) ____________________________ (Work)  ________________________


Mailing Address________________________________________________________


E-mail ______________________________________________________________



Name as it appears on your passport




Passport Number_______________________     Date of Issue: __________________


Place of issue  _______________________             Expiration date : ________________


Delta Frequent Flyer Mile number__________________________________________


It is absolutely essential that the name of the passenger match the name on the passport EXACTLY! Over the past two years the TSA has become very strict with this. If middle names are on passports, but missing or only an initial on the boarding pass, the TSA agents are sending passengers back to the airline to correct the ticket. The passengers are not getting past security. The airlines when dealing with this are imposing fines to both the passenger and the booking agency correcting the error at the airport. The airline is fined by the TSA for not having the correct information when they send over the passenger list to the TSA 72 hours prior to the flight. And if the current class of service is not available, the passenger can be charged full fare for the new ticket. As you can see, this causes a lot of people a whole lot of problems and the folks at the airport just don’t have a sense of humor about this.

IMPORTANT!    Include 1 copy of your passport ID page.


Local Church ______________________________ Pastor ______________________


1. Why do you wish to participate in this mission?  (Please use separate page.)  Tell about yourself, including local church involvement, hobbies, and any other information that might be useful during this mission.


2. The mission will include some fairly rigorous activity and the hours may be long.  Please indicate the general state of your health. Is there anything team leaders should be aware of health-wise (allergies, diet, specific medicines that should not be administered, etc.)?


3. Team members may be asked during church services to give a brief 2-3 minute testimony about their commitment to follow Christ and his impact on their lives.  Do you feel certain that with God’s help you will be able to make such a public testimony?


4. Please check all applicable skills and explain in detail, where appropriate.  We need a clear picture of your skills/abilities to make the mission team as effective as possible.  Team assignments will be made based on this information.


___ Work with children and youth, including recreational skills, storytelling, art, singing, crafts.  Which is best for you? _____________________________________


___Building/carpentry skills.  (Some of the team members must have construction knowledge.)   Please indicate your level of expertise: ___Fair ___Good ___Excellent ___Professional


__ Medical Technician. ___Physician  ___Nurse  ___First Aid training  ___CPR training


__ Singing in worship services __Solos __Duets/trios/small groups__With group only


___ Playing a musical instrument (specify)____________________________________


___ Preaching or giving a prepared talk/devotional         ___ Photography/Videography


To be completed by Applicant:

I understand that team members must be flexible, cooperative, and cheerful.  I agree to cooperate at all times with the Team Leader concerning our life together including daily assignments, food, lodging, and transportation.  I agree to stay with the team from beginning to end.

 _________________________________________         ______________________

Applicant’s signature                                                                                                          Date


To be completed by Applicant’s pastor:

I believe that the above applicant is a dedicated Christian, is friendly, flexible, and able to make a valuable contribution ot the mission team traveling to Liberia.  I am personally acquainted with him/her and recommend her/him for volunteer service.  You may contact me for additional information if needed.

______________________________________________________ _____________

Pastor’s Signature                                                                                                           Date



Send completed application to the Mentor UMVIM Coordinator:

Becky Suran,11945 Briar Wyck Woods   Painseville Ohio 44067

More information contact Becky at                      

________ Yes I would like this information to be used as my MENTOR UMC INTERNATIONAL UMVIM SCHOLARSHIP APPLICATION.