2019 Puerto Rico Project Application
The deadline to apply is March 14th, 2019
A face shot picture is also required so please email one to pbellomy@cccdaytona.org

**Your application is not considered complete until you have submitted your photo**

First Name: *
Legal First Name, required for ticket purchases
Your answer
Middle Name: *
Legal Middle Name, required for ticket purchases
Your answer
Last Name: *
Legal Last Name, required for ticket purchases
Your answer
Date of Birth: *
MM
/
DD
/
YYYY
Email: *
Your answer
Cell Phone: *
Ex: (555) 555-5555
Your answer
Home Address: *
Your answer
Home City, State, Zip: *
Your answer
T-Shirt Size: *
What would you consider your knowledge of Spanish to be? *
Little to Nothing
Fluent
How would you intend to pay for PRP? *
If support raising, how doable do you think it'll be raise 100% of the cost? *
Incredibly Challenging
Easy
School: *
If other, type school:
Your answer
If other, please explain how you found out about the Puerto Rico Project and list two references.
Your answer
Major: *
Your answer
Year in School: *
If other, type year:
Your answer
School Address: *
Your answer
School City, State, Zip: *
Your answer
Personal Information
Please tell us a bit more about yourself
This information will be treated confidentially and will only be seen by individuals directly involved in your application decision and by appropriate leadership. We are concerned about your growth and want to be sure the Puerto Rico Project will be a good environment for you. We may need to discuss the questions further.
Church or religious background, if any *
Your answer
Have you ever: *
Check the box and explain if you feel it is necessary. This info will remain confidential to the leadership of the Puerto Rico Project.
Required
Explain if necessary:
Your answer
Do you have a medical/physical condition that you're currently being treated for? *
This will also remain confidential. It is to make CCC staff aware of any potential needs.
Explain if necessary
Your answer
Do you have any food allergies or dietary restrictions? If so, please list. *
Your answer
Puerto Rico Project Information
What do you believe is the purpose of the Puerto Rico Project? *
Your answer
List your top three specific reasons for believing God is leading you to become a part of the Puerto Rico Project this year? *
Your answer
When and how did you come to know Jesus Christ personally? *
Your answer
How long have you been actively involved with Christ Community Church? *
Are you willing to be trained to share the Gospel with others? *
If no, explain
Your answer
Parental Information
Would your parent/guardian prefer to receive the Parent's Packet with information regarding the Puerto Rico Project in a pdf through email or a hard copy through the mail?
Please describe your relationship with your parent(s) *
Have you discussed your desire to be a part of the Puerto Rico Project with your parents? *
If so, what was their response? *
Parent/Guardian Name *
Your answer
Parent/Guardian Phone - Best contact number: *
Ex: (555) 555-5555
Your answer
Parent/Guardian Email: *
Best email address
Your answer
Important Information:
**The total cost of the Puerto Rico Project is $3,000 and you will be responsible to either raise or pay the entire amount of the trip. **

Deadlines:
Application Deadline: March 14th, 2019
Acceptance Deadline: March 21st, 2019
Commitment Deadline: March 28th, 2019

A face shot picture is also required so please email one to pbellomy@cccdaytona.org

**Your application is not considered complete until you have submitted your photo**

Do you agree to submit to the authority of the Christ Community Church's Puerto Rico Project and its leadership? *
Initials *
Your answer
Application Acceptance
You will hear from Christ Community Church regarding acceptance to the Project by March 22nd.

We will either accept, decline, or wait-list you dependant on a number of factors.

Thank you for taking the time to complete this application and we hope to have you this summer in Puerto Rico!

- Christ Community Church Daytona Beach staff

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