2018 Bread of Life Mission Trip Application
For which 2018 Mission Trip are you applying? *
Please print name as it appears on your passport:
First Name *
Your answer
Middle Name *
Your answer
Last Name
Your answer
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Cell Phone *
Your answer
Home Phone
Your answer
Email Address *
Your answer
Gender
Passport #: *
If you don't have a passport, please use asterisks.
Your answer
Expiration Date of Passport
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Issue Date of Passport
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Birthdate *
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Age
Your answer
Place of Birth *
Your answer
Marital Status *
If under 18 years of age, name of parent(s) or guardian(s) and their cell phone #.
Your answer
Which church do you attend? *
Your answer
Are you currently serving in ministry? If so, where? *
Your answer
Have you served in missions before? (If yes, please include location and general dates.) *
Your answer
Do you have a personal relationship with Jesus? *
If so, please briefly summarize your testimony.
Your answer
I am gifted in the areas of: *
(Please check all that apply.)
Required
Why would you like to participate in this mission trip? *
Your answer
What would you like to accomplish on this trip? *
Your answer
Describe what you think may be the biggest challenge for you to overcome for this project: *
Your answer
Describe your strengths: *
Your answer
Describe your weaknesses: *
Your answer
Do you have a criminal record? If so, please explain. *
Your answer
Please list any medications that you are currently taking, doctor's restrictions you are under, or any medical condition(s) that could affect your health and well being on the trip (including pregnancy).
Your answer
I understand that this trip is an evangelical Christian mission trip and understand that I will be expected to share my faith with others as part of this trip. *
Required
If I am chosen to be part of this team, I commit to the following: *
Required
Insurance and Medical Information
Insurance Provider
Your answer
Insurance ID#
Your answer
Insurance Address
Your answer
Insurance Phone #
Your answer
Insurance Policy Holder
Your answer
Employer Providing Policy (if group policy)
Your answer
Employer Phone # (if providing group policy)
Your answer
Employee Position
Your answer
Insurance Group #
Your answer
*
Required
Emergency Contact Information
Emergency Contact Name *
Your answer
Emergency Contact Relationship *
Your answer
Emergency Contact Address *
Your answer
Emergency Contact Cell Phone *
Your answer
Emergency Contact Home Phone
Your answer
Emergency Contact Email Address *
Your answer
References
Name of Pastor or Spiritual Leader *
Your answer
Church *
Your answer
Phone # *
Your answer
Name of Personal Reference *
Your answer
Relationship *
Your answer
Phone # *
Your answer
Statement of Faith
IN THE ESSENTIALS WE BELIEVE IN UNITY *
There is one Body and one Spirit, there is one Lord, one faith, one baptism, and one God and Father. (Ephesians 4:4-6)
IN THE NON-ESSENTIAL BELIEFS, WE HAVE LIBERTY *
Accept him whose faith is weak, without passing judgment on disputed matters. Who are you to judge someone else's servant? To his master he stands or falls...so each of us will give an account of himself to God... So whatever you believe about these things keep between yourself and God. (Romans 14, 4, 11-12, 22)
THE ESSENTIALS WE BELIEVE *
The sole basis for our belief is the Bible, which is uniquely God inspired, without error, and the final authority on all matters on which it speaks. As the Bible teaches, there is one God, eternally existing in three persons – Father, Son and Holy Spirit – each possessing all the attributes of deity. God created humans to have fellowship with Him, but they have defied God by going their own way. As a result, we need God’s saving grace to end our alienation from Him. Salvation comes only through God’s grace – not human effort – and must be received personally by repentance and faith. Jesus Christ, second person of the Trinity, lived a sinless life on earth and voluntarily paid for our sins by dying on the cross as our substitute. This accomplished salvation for all who receive grace by trusting in Him alone. He rose from the dead and is the only mediator between us and God. He baptizes believers in the Holy Spirit. He will return to earth to consummate history. The Holy Spirit draws sinners to Christ and equips believers for personal growth and service to the church. The church’s role is to glorify God and serve those in need. At the end, everyone will experience bodily resurrection and the judgment. Only believers will enjoy eternal fellowship with God.
My initials below indicate the following: *
I have read the above statement of faith and have circled my own view on these issues. In addition, all information in this application is true and complete. I also authorize Bread of Life Mission to make such inquires into related matters as may be necessary in arriving at an acceptable decision. I hereby release employers, schools or persons from all liability in responding to inquiries in connection with my application in accordance with the liability waiver linked below.
Your answer
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By checking this box, I certify that I have read and agree with the Liability Waiver linked below. *
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