Chicago Student Trip Application!

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We cannot wait for this trip! Join us July 26-30 to visit ministry partners, explore issues and kingdom-minded solutions around poverty and racial reconciliation, and more! Filling out this form lets us know you want to go and more about you. Limited spots available! Deadline to apply: Thursday, May 13.

Estimated Cost: $330 (25% CRBC Member Grant Included)

Name *

Student or sponsor? *

Student

Sponsor

DOB *

YYYY

Grade in School:

Phone Number: *

Place of Employment (or School): *

Medical Information:

Medical Physician's Name & Phone Number: *

Health Insurance Company & Policy Number: *

Are you currently taking any medications? If so, please list below:

Do you have any allergies? If so, please list below:

Are you under the care of a physician due to a physical condition which may limit your ability to serve in some assignments (allergies requiring medications, asthma, vision problems, back problems, difficulty walking long distances, etc.)? If so, please explain below:

In case of an emergency, please notify: *

Relationship: *

Phone Number: *

Church Involvement:

At what church are you a member? *

How long? *

Please list below church activities/ministries in which you are involved: *

Personal Profile:

Would you describe yourself as an introvert, extrovert, or somewhere in the middle? *

Tell us how you became a Christian. When did Jesus change your life? *

Please describe how you are cultivating your relationship with Christ: *

Please provide us with one reference (teacher, family friend, minister, small group leader, etc.) with contact info who knows you well! *

Have you had experience/training in sharing the Gospel? Tell us about it! *

Please tell us the realistic roadblocks that might keep you from going on this short-term mission trip: *

Please describe any experiences that you have had serving on a short-term mission team (Include dates, length, location, and sponsoring organization of any trips): *

Are you a part of CRBC’s core givers (you financially give consistently to CRBC)? *

Trip Commitments:

I will actively participate in providing funds for the trip through personal and/or fundraising and I will provide these funds in due time (before the date of departure): *

This trip will include a lot of learning through readings, tours, and conversations. I desire to learn and will approach difficult subjects with grace, an open mind to different perspectives, and respect for others: *

I will attend the mandatory pre-trip meetings and post-trip debrief: *

I will submit to the team leader's and missionary's authority, serve with a spirit of humility and the utmost flexibility, and strive for biblical unity: *

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