Deadline
Monday, November 16, 2009 (applications accepted from 1
– 3 pm at CUPS)
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Parent’s Name: ______________________________ | ||||
| Parent’s Address: ______________________________ Are your parents aware of your decision to participate in this trip? [ ] yes [ ] no What is their response? [ ] fully supportive [ ] supportive, but with some apprehension [ ] ambivalent [ ] not in favor of participation | ||||
| Medical Info: Ins. Company: ______________________________ | ||||
| Date of last tetanus: __________________ Have you had both Hep A and Hep B vaccines? [ ] yes [ ] no Allergies / Health Concerns / Dietary conditions we should know about for the trip: | ||||
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Local church involvement: ______________________________
Are you a member? [ ]
yes [ ] no
If you are not “Baptist,”
are you willing to work with Baptist missionaries & ministries?
[ ] yes [ ] no if “no” – please explain.
Have you ever been on a mission trip? [ ] yes [ ] no
If “yes” – when, where,
with whom? Describe your experience.
Why would you like to participate
in this trip?
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you a Christian? [ ] yes [ ] no
Please tell a little about how you came to know Christ. | ||||
| What
skills, talents, experiences do you think make you well-equipped to
serve on this trip? This will be a very demanding trip. Are you willing to do whatever you are asked without complaining, questioning, or arguing? [ ] yes [ ] no – of no, please explain “I have read the ‘team member expectations’ and ‘statement of practice’ and agree to abide by those expectations.” Signature: ______________________________ To Do Checklist: Due with application submission | ||||
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| Signature: ______________________________ |
Date: __________________ | |||
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