Ecuador Mission Trip Application

The trip will be June 16-25, 2018 and will cost $3000.
Name:
Phone (888-888-8888):
Address:
City:
State:
Zip:
Campus PMB:
Campus Residence:
Date of Birth (mm/dd/yyyy):
Marital Status:
Contact in case of an emergency.
Emergency Contact:
Contact Phone (888-888-8888):
Contact Emergency Address:
Health Insurance Policy
Company:
Policy Number:
Church Membership:
Church Address:
Church City:
State:
Church Zip:
Will this church help support you financially?:
Yes
No
How else do you plan to raise funds for this trip?:
Have you ever been on a mission trip before? If so, where?:
What were your responsibilities:
Have you ever shared with another person your Salvation experience?:
Yes
No
Are you willing to attend all the orientation sessions to prepare for this trip?:
Yes
No
Do you have any experience speaking Spanish?:
Yes
No
List some of your talents and abilities which you think will be beneficial to this team?:
Briefly give your testimony in a short paragraph:
How did God speak to you about being a part of this mission trip:
What do you hope God will do in your life while on this trip?:
Passport Name:
Passport Number:
Passport Expiration Date:
I have read the qualifications and filled out this application to the best of my ability.
I agree:
Yes
No
Please email a copy of your schedule along with your application so that a meeting time can be planned.