Please fill out the form below.  If you leave this page, your responses will not be saved, so be careful!   Once submitted, your application will be transmitted to our office and a backup copy will be sent to your inbox.

Information About You

Full Legal Name

Preferred Name


Cell Number



Your major

Year in School

Home Church

Campus Address

Home Address

Tshirt Size

Do you have any scheduling conflicts with leaving on the designated day/time?

Emergency Contact

Emergency Contact Name

Emergency Contact's relationship to you

Emergency Contact's home address

Emergency Contact's cell #

Emergency Contact's email


Have you been on this missions trip before?

Are you dating anyone that also may be coming on this trip?

If yes, who?

Why do you want to go on this trip? What might you learn, gain, or experience?

What strengths do you bring to the team?

What are some areas in which you hope to grow through this project?

What's your current involvement in the body of Christ? (i.e. home church, places you serve, etc...)

Briefly share your spiritual history.

What is your personality like? (i.e. Are you outgoing or reserved? Do you avoid conflict or confront it?)

Please provide information regarding any medical conditions (allergies, prescriptions, previous surgeries, dietary issues, history of emotional or mental illness, addictions, etc...) that could play a factor in this trip.

Anything else we need to know?

I agree that my role on this trip is to be a representative of Christ. I will submit to the leadership assigned to my team and have an attitude of love and service for those around me.
I agreeI disagree

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