Spring Break Trip Application
Name *
Your answer
Date of Birth *
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Phone # *
Your answer
Email Address *
Your answer
Mailing Address *
Your answer
Do you regularly participate in Chi Alpha’s Thursday evening service? *
Do you attend a local church? *
If yes, what local church do you attend? *
Your answer
How often have you gone in the past 3 months? *
Are there any ways in which you have been/do you plan on serving the community of Chi Alpha this year? *
Your answer
Have you had any outreach/missions experiences before now? *
If so, please describe the nature of each experience below:
Your answer
Why do you want to go on this trip? *
Your answer
Would your Core leader (or those close to you) describe you as teachable? *
Your answer
Would your Core leader (or those close to you) describe you as faithful? *
Your answer
On a scale of 1-10, how familiar are you with the Bible and its teachings? *
Not Very Familiar
Super Familiar
Explain your answer. *
Your answer
Are there currently any circumstances in your life-whether physical, moral, or other-that would make it difficult for you to be an effective team member? *
If so, please explain below:
Your answer
Please state your basic understanding of the good news of Jesus. *
Your answer
How comfortable are you approaching strangers and talking to them about the Gospel? *
Your answer
Please share with us the character qualities, commitments and habits you believe are essential for a spring break missionary to have. Which do you see in your own life? *
Your answer
Please tell us a bit about your devotional life (prayer times, reading the Bible, etc). *
Your answer
What does outreach look like in your life currently? *
Your answer
If needed, would you have a roadworthy car to take along on a team trip? *
I will be able to participate fully in an orientation program, including background reading, and team meetings. *
I understand that this preparation will require a time commitment. *
I will be available to leave immediately following Winter Finals. *
I have spoken with my parents about going on this Spring Break trip. *
I am willing to modify any personal and/or social habits (behavior and appearance), which in the opinion of the local leader's might interfere with the team's health, my own well being, or my Christian witness. *
I understand that I am responsible for my own finances and that I am expected to raise my entire support in order to go on this trip. *
If selected for the team, I am willing to stay in a house or building with other team members during the trip, and be respectful of any team times of study, worship, prayer, and common life together as established by the team leaders. *
Full Legal Name (what's on your ID) *
Your answer
Emergency Contact (Name & Number) *
Your answer
Secondary Emergency Contact (Name & Number) *
Your answer
Put three one hour blocks of time that you would be available to be interviewed between January 23rd - 25th. One of your campus pastors will contact you to finalize a time. *
Your answer
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