Signed______________________________________
Parents
or Contact Person
Name_______________________________________________________
Phone(____)______________
Home Address ______________________________________________________
City_______________________________State____________Zip________________
Do your parents/contact
person know about the trip? ___Yes___No
If Parents, have they said
you can go on this trip?
___Yes___No
Health
Insurance Information
Company_________________________________________________
Policy No.______________________
Who should be contacted
in case of an accident?
Name_____________________________________________________
Phone (____)____________
Address_____________________________________
City_________________________State________________
Car
Insurance Information (those 25 and older or driving only)
Company_________________________________________________
Policy No.______________________
Would your company cover
an accident if you were driving a rented van
that does not have collision
insurance? ____Yes ___No
Church
Endosement
What church will you seek
to endorse you on this trip?_______________________
Are you a member of this
church ? _ Y _ N How long a member ? ______
Talent
(If appropriate)
What Musical instruments
do you play well ? ______________________
What part do you sing well
? ______________________
Have you or do you currently
sing or play on a worship team ? __ Yes __ No
If so where ? ___________________
How long ? ____________________
Commitment
to Jesus
Have you ever prayed to
receive Jesus Christ as your personal Lord and Savior?
___Yes ___No
When? ______________ Where?_________________________
Mission
Trip Involvement
Have you ever been on a
mission trip before? ___Yes ___No
If so, where and what were
your responsibilities?__________________________
__________________________________________________________________
Witnessing
Involvement
Have
you ever particiated in evangelism training ? __ Yes __ No
When
? __________________ Where ? ________________________________
Have you ever shared with
another person how you came to know Jesus Christ
as your Lord and Savior?
__Yes__No
Do you feel comfortable
telling others about Jesus? __Yes __No
Would you feel more comfortable
if someone went with you? __Yes __No
Integrity/Character
Are you willing to abstain
from the use of alcoholic beverages and illegal drugs
while on this trip?
__Yes __No
Are you willing to abstain
from sexual immorality while on this trip? __Yes __No
Are you willing to abstain
from the use of tobacco products while on this trip ?
__ Yes __ No
Leadership
Availablity
If asked to be a group leader
would you be willing to serve as one ? __ Yes __ No
Committment
Statements
Briefly discuss your present
relationship with Jesus Christ
_____________________________________________________________________
_____________________________________________________________________
______________________________________________________________________
Briefly explain why you
want to go on this mission trip.
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
What do you want God to do
in your life while on this trip?
_____________________________________________________________________
_____________________________________________________________________
______________________________________________________________________
I have read the qualifications
and filled out the above application to the best of my ability.
I am willing to abide by
all the specifications listed and fully understand that any violation
of these standards will
be grounds for asking me to leave the mission trip at my own
expense.
Signed________________________________________________