Short Term Missions Application
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Email *
What trip are you applying for? *
Today's Date *
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Name (as printed on passport) *
Address 1 *
Address 2
City *
State *
Zip/Post Code *
Home Phone
Cell Phone
Age *
Gender *
Country of Citizenship *
Do you have a passport? *
Passport # *
Passport Expiration Date *
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Date of Birth *
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Marital Status *
Emergency Contact Name *
Emergency Contact Email
Emergency Contact Phone
Shirt Size
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Have you ever served on a missions trip or had any cross-cultural experience? *
If Yes, explain.
Explain briefly why you want to participate in this mission trip. *
Please list any skills or talents that may be found useful on this trip.
Please list all languages spoken fluently
List any conditions you have which might affect your ability to fully function as a missionary on this trip. (i.e. fear of flying, depression, anxiety, sleeping disorder)
If you have any chronic illnesses or allergies please list them here.
Are you presently under medication prescribed by a doctor?
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How would you describe your health and fitness? *
Have you ever been convicted of committing a crime? *
If yes, explain.
If applying for a trip that includes ministry to children, you may be required to have a background check. Do you agree to a check? *
I have read and understand the above information. The information I have given is accurate and true to the best of my knowledge. *
Required
A copy of your responses will be emailed to the address you provided.
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