Chicago Student Trip Application!
We cannot wait for this trip! Join us March 16-20 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: September 18th.

Estimated Cost: $330 (25% CRBC Member Grant Included)
Name *
Your answer
Student or sponsor? *
DOB *
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Grade in School:
Your answer
Phone Number: *
Your answer
Place of Employment (or School): *
Your answer
Medical Information:
Medical Physician's Name & Phone Number: *
Your answer
Health Insurance Company & Policy Number: *
Your answer
Are you currently taking any medications? If so, please list below:
Your answer
Do you have any allergies? If so, please list below:
Your answer
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:
Your answer
In case of an emergency, please notify: *
Your answer
Relationship: *
Your answer
Phone Number: *
Your answer
Church Involvement:
At what church are you a member? *
Your answer
How long? *
Your answer
Please list below church activities/ministries in which you are involved: *
Your answer
Personal Profile:
Would you describe yourself as an introvert, extrovert, or somewhere in the middle? *
Your answer
Tell us how you became a Christian. When did Jesus change your life? *
Your answer
Please describe how you are cultivating your relationship with Christ: *
Your answer
Please provide us with one reference (teacher, family friend, minister, small group leader, etc.) with contact info who knows you well! *
Your answer
Have you had experience/training in sharing the Gospel? Tell us about it! *
Your answer
Please tell us the realistic roadblocks that might keep you from going on this short-term mission trip: *
Your answer
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): *
Your answer
Are you a part of CRBC’s core givers (you financially give consistently to CRBC)? *
Your answer
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): *
Your answer
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: *
Your answer
I will attend the mandatory pre-trip meetings and post-trip debrief: *
Your answer
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: *
Your answer
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