Missions Application
Disclaimer: Completion of this form does not guarantee a spot on the mission. You will be notified once you receive approval from CBC.
Email address *
Personal Information
Interested in going to a CBC mission? Great! Please fill out this form!
Name *
First and last name as on your passport
Phone number *
Birthdate *
MM
/
DD
/
YYYY
Place of Birth (country) *
Home Address *
Street, address, city, state, zip code
Are there any health concerns we should know about? Do you take any prescription medications?
If yes, please explain, we need to know anything we can do to to keep you safe!
Do you have a valid passport? *
International missions require a passport. If you don't have a passport at the time of the mission, you will not be allowed to cross the border!!! It's the law!!! Please give the trip leader your passport information as soon as possible!!!!!!!!!!!!!!
Passport Number/ Issue Date
Place of Passport issue (city/state)
Passport expiration date
T- Shirt size (unisex) *
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