Mission Trip Details
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Please print, fill out, and turn in on Sunday
 
 

APPLICATION FOR PANAMA MISSION TRIP

June 18-30, 2004

Name (Mr. Mrs. Miss) __________________________________________________________

 

Present Address            ____________________________________________________________

 

____________________________________________________________

(city)                                                      (state)                                       (zip)

Home Phone: ______________        Work Phone:  ________________

 

Grade in school - Fall of  2004:  9   10   11   12   College    Adult  (circle one)

 

Occupation for adults ____________________________________________________________

Skills, Talents (Please list below):

______________________________________________________________________________

______________________________________________________________________________

 

Describe your ability and experience in each:

 

______________________________________________________________________________

______________________________________________________________________________

 

       MEDICAL INFORMATION

 

1.         Do you have any physical limitations or emotional disorders?             Please explain.

 

________________________________________________________________________

________________________________________________________________________

 

2.         Do you have any medical problems?  If so, list them.

 

________________________________________________________________________

________________________________________________________________________

 

3.         Have you had major surgery in the past 12 months?  If so, explain.

 

________________________________________________________________________

________________________________________________________________________

 

4.         Are you presently taking any prescription or nonprescription medicine on a regular basis?  If so, list.

________________________________________________________________________

________________________________________________________________________


 

5.         Are you allergic to any medication?  If so, list.

 

________________________________________________________________________

________________________________________________________________________

 

6. Include the following three questions in a typed or written essay, and return with your application.

 

1. Describe you relationship with Jesus Christ. What is your favorite scripture verse and why?

2. Why do you feel God is leading you to be a part of this mission trip? ( were you moved by a video you saw, have you talked to missionaries, etc.)

3. Why do you feel there is a need for missions?

 

Personal strengths:

______________________________________________________________________________

______________________________________________________________________________

 

Personal weaknesses:

______________________________________________________________________________

______________________________________________________________________________

 

Please list three (3) references.

 

Name

 

 

 

 

 

 

 

Address

 

 

 

 

 

 

 

Phone

 

 

 

 

 

 

(1)                                             (2)                                            (3)

I understand that this is an application form that must be reviewed and involves a personal interview before any decision is made for me to attend this short term mission trip.

 

Signature _____________________________________________________ Phone __________

 

Parent's Signature (if applicable) __________________________________________________

 

Applications should be returned to the church office by Sunday, November 16th , 2004

 

 

 

 

 

 

 

 

 

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