Belize Individual Sign up Application 2023

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CMT offers mission trips for individual sign ups. This form is for individuals 18+ who wish to sign up for 2023 that do not have a group. This includes single young adults, adults, siblings, and married couples. Mission week runs Monday July 31, 2022 -Saturday August 5, 2023. Cost $1,000 per person. This does not include transportation to Punta Gorda, Belize. You must arrive to Punta Gorda, by 5 pm on Monday July 31, 2023.

"Life with Christ is a wonderful adventure." -Pope Saint John Paul II

Name *

Last, First Middle (Nickname)

Gender *

Male

Female

Date of Birth *

YYYY

Age *

Mailing Address *

Street, City, State, Zip

Phone Number *

List the best number to reach you, leading up to the mission trip.

Mission Trip Dates *

July 31 - August 5, 2023

Required

Have you served with us before? *

Yes

Maybe

What is motivating you to want to go on a mission trip? *

Profession

I will be attending this mission trip as *

an individual

with my family

with my friend

Other:

If so, what are their names? What is their relationship to you? If children, please list ages.

Do you have a friend or family member that you would consider inviting to come with you or someone that would consider joining the mission trip with you?

Friend or family member's email:

Home Parish & Diocese *

T-Shirt Size *

Small

Medium

Large

X-Large

XX-Large

XXX-Large

T-shirt size for other attending family members:

Allergies?

Personal Health and History

Missionary work is intense, physically, mentally, and spiritually. Being healthy in each of these areas is important, especially when keeping the safety of the people we will be serving in mind. Please select any/all to which your answer is "yes". Please note that a "yes" does not automatically exclude you from the mission.

Have you ever been convicted of committing a crime?

Have you ever been involved with illegal drugs?

Have you ever been involved with a cult or the occult?

Have you ever had psychiatric care?

Have you ever taken medication for depression or anxiety?

Have you ever taken medication for behavior?

Have you ever had diabetes or hypoglycemia?

Have you ever had seizures?

Have you ever had fainting spells?

Have you ever had breathing problems?

Have you ever had a serious allergic reaction?

Do you have any current contagious medical conditions?

Have you ever been on a mission trip before?

Other:

Clear selection

If you answered "yes" to any of the above questions, please explain.

Interpersonal Skills: On a scale of 1-10, with 10 being the highest/strongest, please evaluate your personal strengths and weaknesses. *

Relating to people very different than you

Establishing friendships *

Maintaining friendships *

Sense of humor *

Ability to finish what is started *

Problem solving *

Humility *

Encouragement *

Listening *

Conversing with strangers *

Ability to submit to/obey authority *

Being an example *

Acknowledge mistakes/ask forgiveness *

Flexibility with changes in schedules *

Explain any of the above ratings that you feel need clarification.

Experience *

Describe any prior mission trip experience you have had.

Describe your experience with construction.

Expectations

What are your personal expectations?

Would you like help fundraising for your mission trip?

Do you have any questions for us?

Thank you! We will reach out when we have received your application.

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