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Short Term Missions Application
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* Indicates required question
Email
*
Your email
What trip are you applying for?
*
Guatemala Team (October 19th - 26th, 2024)
Guatemala Team (March 2025)
Today's Date
*
MM
/
DD
/
YYYY
Name (as printed on passport)
*
Your answer
Address 1
*
Your answer
Address 2
Your answer
City
*
Your answer
State
*
Your answer
Zip/Post Code
*
Your answer
Home Phone
Your answer
Cell Phone
Your answer
Age
*
Your answer
Gender
*
Male
Female
Country of Citizenship
*
Your answer
Do you have a passport?
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Yes
No
Passport #
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Your answer
Passport Expiration Date
*
MM
/
DD
/
YYYY
Date of Birth
*
MM
/
DD
/
YYYY
Marital Status
*
Single
Married
Emergency Contact Name
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Your answer
Emergency Contact Email
Your answer
Emergency Contact Phone
Your answer
Shirt Size
XS
S
M
L
XL
XXL
3X
4X
Clear selection
Have you ever served on a missions trip or had any cross-cultural experience?
*
Yes
No
If Yes, explain.
Your answer
Explain briefly why you want to participate in this mission trip.
*
Your answer
Please list any skills or talents that may be found useful on this trip.
Your answer
Please list all languages spoken fluently
Your answer
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)
Your answer
If you have any chronic illnesses or allergies please list them here.
Your answer
Are you presently under medication prescribed by a doctor?
Yes
No
Clear selection
How would you describe your health and fitness?
*
Excellent
Good
Fair
Poor
Have you ever been convicted of committing a crime?
*
Yes
No
If yes, explain.
Your answer
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?
*
Yes
No
I have read and understand the above information. The information I have given is accurate and true to the best of my knowledge.
*
I agree
I disagree
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