CC Grace Fellowship-Far Reaching Ministries Application for Short-Term Trip (TABS)

Short-Term Ministry Application

For teaching pastors, team members, and individuals. Fill out the form carefully.
Thank you for applying for a short-term missions trip with CC Grace Fellowship Far Reaching Ministries.

Before you begin, please gather the following:
- Scans/Photos of the following:
  - Passport Bio ID page
  - Driver's license
  - Vaccination cards
- Your church's address
- Prescription medication information
- Health insurance information
  - Policy number, etc.
  - Does it cover you internationally?
  - Does it include international medical evacuation?
When you begin, please start at the beginning and proceed to each successive section. If you jump ahead, you may answer questions you don't need to.

The questions are so we can get to know you. So, please also reflect on your trip expectations, apprehensions, and personal strengths/gifts. There are a few questions about your spiritual beliefs.

Medical-related questions are included. The information you provide is stored in HIPPA-compliant computer servers, and you will see a blue "HIPPA-Compliant" symbol on the screen.

Two personal references may be required, especially if traveling with a team. If references are required, we will e-mail them immediately after you submit this application. Please get in touch with them quickly so they can expect our e-mails.

A background check is required for most applicants. You can make the payment near the end of this application. FRM or CC Grace Fellowship will receive your payment and then pay the background check company.

Required Fields must be completed before final submission.

Some sections may not apply to you. In these cases, you will see a message to that effect. Click "Next" to move forward to the next section.

You can SAVE your progress and return to your application later.

Our criteria for mission team members are multi-faceted and include this application, dialogue with your church staff, and other items.

We will prayerfully review your application and assess your suitability for this trip. Thank you for applying!

Click NEXT to begin your application.

General Information
Applicant Name - as it appears on your passport*

First NameMiddle NameLast Name
Birth Date*

MonthDayYear
Gender*
Today

MonthDayYear
Date
Age
Country applying to serve in?*
Example: DR Congo, South Sudan, etc.
What month is this trip?*
How will you be serving?*
Were you ordained?*
Who ordained you?*
If this is with a group or church, list the name here.
If none, leave blank
Have you been on an FRM trip before?*
What country or countries?*
What is your FATHER'S NAME?

First NameLast Name
What is your MOTHER'S NAME?

First NameLast Name
What is YOUR PROFESSION / JOB?
This information is REQUIRED the 2021 D.R.C trip.

Passport Information
Passport Number*
Issuing Country*
Passport Expiration Date*

MonthDayYear
Must be valid for at least 180 days for admission to some countries.
Passport Valid (months)
Upload Your Passport Bio ID Page Image*

JPG, BMP, or PDF preferred.
Cancelof

Driver's License Information

This information is used for your background check (if required)
Driver's License Number*
Issuing State*
For a U.S. territory or Canada, select "OTHER."
Issuing Territory/Province*
Upload Driver's License Image*

JPG, BMP, or PDF preferred.
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Contact Information
Your Mailing Address*

Street Address

Street Address Line 2 (if needed)

CityState / Province

Zip / Postal Code
Email*
example@example.com
Home Number
Cell Number
Work Number
Company Name
Best number to contact you
When is the best time to contact you?

Personal Information
Marital Status*
What is the full name of your spouse/fiancé?
How long have you been married/engaged?
How many years have you been widowed?
How many years have you been divorced?
How many years have you been separated?
Is your spouse/fiancé aware you applying for this trip?*

Education Background
Did you graduate from high school?*
Highest grade completed*
List any education beyond high school*
List school name, location, dates, major/minor, degree or hours completed.
List any formal Bible training*
List school name, location, dates, major/minor, degree or hours completed.

Your Church
What is the name of your church?*
Church Address*

Street Address

Street Address Line 2 (if needed)

CityState / Province

Postal / Zip Code
Church's website

Your Trip Expectations
What are your concerns or fears about this trip?*
What are your expectations for this trip?*

Your Christian Beliefs
Who is the Holy Spirit?*
What is your relationship to the Holy Spirit?*
What is your position about spiritual gifts in the life of the believer?*
What is your most significant experience as a Christian?*
We'd Like To Know More About You
What are some of your spiritual gifts or unique skills?*
Please describe and give of an example of when you used them.
What are some books or magazines you read in the last 12 months?*
Describe your travel to developing countries.*
How do you manage stress? Please give a specific example of the last time you were stressed or frustrated and how you managed it.*

Medical Information
What is your blood type?*
Is your blood Rh(+) or Rh(-) ?*
Do you have have/use any medical devices?*
Examples: pacemaker, insulin pump, CPAP, etc.
Please describe the device.*
Do you have any allergies?*
Allergies to pollen, food, medication, or anything else
Please describe the allergy.*
Do you have an EpiPen?*
Please describe any other allergy-related information here.*
If none, write "None."
Do you have any chronic medical conditions?*
Please list each medical condition.*
Do you have any psychiatric conditions?
Depression, bipolar, etc.
Please list each psychiatric condition.*
Are you taking any prescription medications?*
Please list each prescription medication, dosage, and use.*
Example: Enalapril 10mg. Twice daily. Blood pressure.
Do you have any fears or phobias*
Examples: claustrophobia, fear of water, etc.
Please describe it in detail and how you manage it.*
Do you have an advanced health care directive?*
FRM may request a copy in the case of emergency

Vaccination History

See www.fda.gov/vaccines-blood-biologics/vaccines/vaccines-licensed-use-united-states for vaccine names and types.
Received Tetanus/Diphtheria vaccine?*
Tdap, Td, others
Vaccination date - tetanus/diphtheria*

MonthDayYear
CDC: Tdap or Td every 10 years
Tetanus/Diphtheria Valid Until (calc.)

MonthDayYear
Date
Received Meningococcal vaccine?*
Bexsero, Menactra, Menveo, Trumenba
Vaccination Date - meningococcal *

MonthDayYear
CDC: 1-3 doses only, depending on vaccine, etc. Boosters only in special circumstances.
Received Hepatitis A vaccine?*
Havrix, Twinrix, VAQTA
Vaccination Date - hepatitis A*

MonthDayYear
CDC: 2-3 doses only, depending on vaccine
Received Hepatitis B vaccine?*
Engerix-B, HEPLISAV-B, Recombivax HB, Twinrix
Vaccination Date - hepatitis B*

MonthDayYear
CDC: 2-3 doses only, depending on vaccine
Typhoid Vaccine is Either ORAL or I.M. Injection

Did you get the ORAL (Typhim Vi) or I.M. (Vivotif)?
Received TYPHIM Vi oral typhoid vaccine?*
TYPHIM Vi
Vaccination Date - ORAL typhoid*

MonthDayYear
CEC: ORAL Typhoid good for 2 years.
ORAL (TYPHIM Vi) valid until (calc.)

MonthDayYear
Date
Received Vivotif I.M. typhoid vaccine?*
Vivotif
Vaccination Date - I.M. typhoid*

MonthDayYear
CEC: I.M. Typhoid good for 5 years.
I.M. Typhoid (Vivotif) valid until (calc.)

MonthDayYear
Date
Yellow Fever and Covid Vaccines

Several countries require Yellow Fever and Covid vaccination for entry.
Received Yellow Fever vaccine?*
YF-Vax
Vaccination Date - yellow fever*

MonthDayYear
One vaccination for life.
Received COVID-19 vaccine?*
Vaccination Date - covid-19*

MonthDayYear
Your Vaccination Records

The Yellow Fever vaccine is usually on a separate card. Please upload it if you have one.
Upload copies of your vaccination records*

JPG, BMP, or PDF preferred Attach as many files as necessary.
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Anti-Malaria Medication

You will be required to bring anti-malaria medication. Which anti-malarial medication for you to take is decided by your physician.

FRM only requires that you do NOT take Larium (mefloquin) because of its potential to cause severe side effects.

Expect an FRM representative to contact you about what anti-malaria medication you will be taking.

Health Insurance
Do you have health insurance?*
Insurance Company
Insurance Company's Phone Number
Please enter a valid phone number.
Policyholder's Name
Policy Number
Leave blank if not applicable
Insurance Group Number
Leave blank if not applicable
Does this policy cover you internationally?
Does this policy cover international medical evacuation?*
Do you have a secondary carrier?*
Secondary Insurance Company
Secondary Insurance Company's Phone Number
Please enter a valid phone number.
Secondary Policyholder's Name
Secondary Policy Number
Leave blank if not applicable
Secondary Insurance Group Number
Leave blank if not applicable
Does this policy cover you internationally?*
Does this policy cover international medical evacuation?*

Emergency Contact
In the event of an emergency, who can we contact?*

First NameLast Name
Relationship to you?*
Example: Spouse, daughter, etc.
Emergency Contact's Phone #1*
Emergency Contact's Phone #2
Emergency Contact's Email*
example@example.com
Is there another way to contact this person?
WhatsApp number, etc.

Release Consent of photos, video, and audio
I, the applicant, hereby grant permission to Far Reaching Ministries and Far Reaching Ministries Aviation (FRM/FRMA) and those acting under its direction, to copy, use, publish, display, produce, duplicate and/or distribute the photographic, video and/or sound recordings of me.

I further grant permission to FRM/FRMA to use segments or portions of the photographic, video, and/or sound recordings of me or my child. For announcements, informational film clips, web clips and/or other uses they deem necessary to provide information, advertisement and/or publicity for Far Reaching Ministries and Far Reaching Ministries Aviation and their ministry efforts. (Examples of this include, but are not limited to, web site postings, newsprint/magazine ads, newsletters, brochures, postcards, invitations, program covers, outdoor banners, signs, marquee posters, correspondence, informational or promotional videos and video clips for website).

This release is a donation to FRM/FRMA Ministries and I do not expect any compensation in return for the grant of use per this consent. Further, FRM/FRMA has not advised as to the value of said donation, nor whether or not said donation is tax deductible. While FRM/FRMA will acknowledge receipt of this material/donation, I personally assume any and all responsibility/liability should I seek to deduct this donation from my income taxes.

I hereby further grant permission for FRM/FRMA the right to use any photos, (digital or negative) and/or video and audio that I have obtained during my mission trip(s) and I agree to supply to these photos, videos and audio to FRM/FRMA in a timely manner. I understand that Far Reaching Ministries will use this media content that I provide for the same purposes mentioned herein above.

Character References

List two references.
FRM requires two references. We will e-mail confidential forms to these two references when you submit your application.
Name of Reference #1*

First NameLast Name
How do you know Reference #1?
E-mail of Reference #1*
example@example.com
Phone Reference #1*
Name of Reference #2*

First NameLast Name
How do you know Reference #2?
E-mail of Reference #2*
example@example.com
Phone Reference #2*

Far Reaching Ministries Code of Conduct
• Pray in all things. Luke 18:1, John 15:5

• Respect the vision and heart of the FRM missionaries and employees.

• Develop and maintain a servant’s attitude toward all nationals and my teammates. Philippians 2:2-4

• Respect my team leader(s) and his or her decisions. 1 Thessalonians 5:12-13

• Not leave my assigned area of ministry or separate myself from my assigned group without first obtaining permission from the team or group leader(s) assigned to me. Proverbs 8:33

• Refrain from gossip. I may be surprised at how much each person will blossom when freed from the concern that others may be passing judgment. Romans 12:4-6

• Not curse or swear. I will let my words be edifying to my team members, local missionaries, and the people we are serving. Ephesians 5:29

• Refrain from complaining. I know that travel can present numerous unexpected and undesired circumstances, but the rewards of conquering such circumstances are innumerable. I will try to be creative and supportive. Ecclesiastes 5:2

• Respect the work that is going on in the country with the particular church(s) or person(s) with whom we are working. I realize that our team is here for just a short while, but that the local church is here for the long term. I will respect their knowledge, insights, and instructions. Ephesians 5:21

• Refrain from negative political comments or hostile discussions concerning our host country’s politics. Romans 13

• Not be exclusive in my relationships. If my fiancé or spouse is on the trip, we will make every effort to interact with all members of the team, and not just one another. I will not show any public displays of affection even if we are married or engaged. 1 Timothy 4:12

• Refrain from any activity that could be construed as a romantic interest toward a national or teammate. I realize certain activities that seem innocent in my own culture may seem inappropriate in others. 2 Corinthians 3:2-3

• Abstain from the consumption of alcoholic beverages, the use of tobacco, or any un-Christ like behavior while on the trip. Galatians 5:16-26

• Eat all my food. I will swallow any and all food given to me without a disgusted or displeased look on my face. Proverbs 6:16-17

• I agree to not burp or pass gas in public. This is highly offensive in many cultures.

• Dress appropriately according to customs of the country. 1 Corinthians 12:23

Background Check - Disclosure and Authorization
Terms and Conditions
Far Reaching Ministries or Calvary Chapel Grace Fellowship may obtain information about you from a third party consumer reporting agency. Thus, you may be the subject of a background invesigation report which may include information about your character, general reputation, personal characteristics, and/or mode of living, and which an involve personal interviews with sources such as your neighbors, friends, or associates.

These reports may contain informatoin regarding your credit history, criminal history, social security identification, motor vehicle records ("driving records"), military records, verification of education or employment history, or other background checks.

You have the right, upon written request made within a resonable time, to request disclosure of the nature and scope of any "investigative consumer report" prepared by contacting Far Reaching Ministries and Clear Investigative Advantage, LLC, 1330 Legacy Dr., Suite 307, Frisco, TX 75033, 888-CIA-2503 (888-242-2503). For information about Clear Investigative Advantage's privacy practices, see www.ciaresearch.c om. The scope of this notice and authorization is not limiteed to the present and, if you are approved for this trip, will continue to the exent permited by law and unless revolked by you in writing. The back ground check organization may change if we as needed.
NOTE:
- FRM will need your social security number to conduct a background check.
- Expect an FRM staff member to call you and ask for your social security number.
How do you want to pay for the background check?
Please mail a check for $35.00 to:

Far Reaching Ministries
38615 Calistoga Drive, Suite 100
Murrieta, CA 92563

Please list your name and the words "background check" in the memo.

The background check fee is non-refundable.

Non U.S. Applicants: please select "Other" and contact the FRM office.
After submission, you will automatically receive a PDF from us called "Volunteer Authorization Form." It is related to your background check.

Please complete the form and e-mail it back to FRM so we can begin your background check (if required).
Yes, you can call and arrange payment for your background check.

FRM's number is (951) 677-4474
Office hours are Monday through Friday, 8:30 AM – 5:00 PM (Pacific Time)

Sign & Submit the Application
By my name and signature below, I affirm that all the statements in this application are true and accurate to the best of my ability. I recognize that if I have lied or misrepresented the truth in any way, I will not be eligable to serve with Far Reaching Ministries.
Name*

First NameMiddle NameLast Name
Signature*

Clear
Please verify that you are human*
Should be Empty:

Short-Term Ministry Application

General Information

Passport Information

Driver's License Information

Contact Information

Personal Information

Education Background

Your Church

Your Trip Expectations

Your Christian Beliefs

We'd Like To Know More About You

Ministry Interests, Part 1

Ministry Interests, Part 2

Medical Information

Vaccination History

Typhoid Vaccine is Either ORAL or I.M. Injection

Yellow Fever and Covid Vaccines

Your Vaccination Records

Health Insurance

Emergency Contact

Release Consent of photos, video, and audio

Character References

Nature of the Trip

Far Reaching Ministries Code of Conduct

Background Check - Disclosure and Authorization

Sign & Submit the Application