Wufoo

Mission Trip Application

It is such a privilege to partner with our brothers and sisters around the world and we are so excited that you are interested in going on a trip. That's awesome!

We want to start this process by getting to know you better. Please fill out this entire application carefully and thoughtfully. Accurate information will help us serve together better.

What trip are you interested in? *
Dominican Republic November 12-21 (Adults) Honduras December 31-January 8 (College Students) Dominican Republic, February 4-13, 2011 (Adults) Honduras, March 4-12, 2011 (College Students)
Application Date * MM / DD / YYYY
GENERAL INFO
Name * First Last
First, Middle and Last Name as spelled on legal documents. ie. Passport, Drivers License *
Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone Number ### - ### - ####
Parent/Guardian Phone Number ### - ### - ####
(for students only)
Email *
Parent/Guardian Email

(for students only)
Male Female
Birth Date * MM / DD / YYYY
Passport Number

(for international trips only)
Passport Expiration Date: mm/dd/yyyy
Students:
School

(for students only)
Grade

(for students only - List current year or year you have just completed)
Father's name

(for students only)
Mother's name

(for students only)
Stepfather's name

(for students only)
Stepmother's name

(for students only)
Adults:
(for adults only)
Spouse's name

(for adults only)
Children's Name(s)

(for adults only)
(for adults only)
(for adults only)
(for adults only)
(for adults only)
Profession
Employer
EXPERIENCE AND SKILLS
Have you participated in any other mission trips before?
Yes No
If yes, please provide location, role and dates
Are you or have you ever been involved in church ministry?
Yes No
If yes, please provide which ministry and your role
Do you have musical experience?
Yes No
If yes, in what areas are you gifted?
Worship leading Singing Guitar Bass Keyboard Percussion Other
Do you have medical skills?
Yes No
If yes, please provide the type of licensing and area of expertise
Do you have construction skills?
Yes No
If yes, check areas of experience
Mason Carpentry Electrical Plumbing Contractor Other
If yes, are you licensed in any specific areas?
Do you have teaching skills?
Yes No
If yes, indicate which age groups you are more comfortable with
0-6 yr. olds Elementary age kids Middle school students High school students College students Adults
TEMPERAMENT AND CHARACTER

Please evaluate the following statements carefully.
	Always	Most of the time	Sometimes	Very rarely	Never
I assume and carry out duties or obligations	1	2	3	4	5
I adjust well to changes in circumstances	1	2	3	4	5
I move ahead in the face of adversity	1	2	3	4	5
I present myself well and have good manners	1	2	3	4	5
I demonstrate confidence in interactions with others	1	2	3	4	5
I work well with others	1	2	3	4	5
I present and evaluate thoughts with clarity and logic	1	2	3	4	5
I relate appropriately with the opposite sex	1	2	3	4	5
I demostrate a mature and consistent walk with God	1	2	3	4	5
I respond well to stressful situations	1	2	3	4	5
I accept and understand myself	1	2	3	4	5
I have an active, positive personal influence for Christ	1	2	3	4	5
I am able to direct, guide or influence people	1	2	3	4	5
I possess skills necessary for quality leadership	1	2	3	4	5
I respond well to authority	1	2	3	4	5

TESTIMONIAL QUESTIONS

Please answer these questions honestly and thoughtfully
How did you come to know Jesus Christ as your personal Lord and Savior?
What has God been doing lately in your life? Describe your daily walk with Him.
What would you say if asked how one can have a personal relationship with God?
What is the most challenging thing you've ever done? Why?
Why do you believe God is leading you to join this mission experience? What are some of the things you'd like to see happen?
What are your strengths and weaknesses that might contribute/affect this trip?
What are some of your fears and apprehensions about this mission experience?
What do you expect from this mission experience? What do you expect from your leaders?
Do Not Fill This Out

Wufoo

Mission Trip Application

GENERAL INFO

Students:

Adults:

EXPERIENCE AND SKILLS

TEMPERAMENT AND CHARACTER

TESTIMONIAL QUESTIONS