CR 2024 - CCGF Mission Trip Application

Mission Trip Application

For teaching pastors, team members, and individuals. Fill out the form carefully.
Please fill out this form to apply for a mission trip with Calvary Chapel Grace Fellowship.

The estimated cost of a mission trip with CCGF is $1500.

Before you begin, please gather the following:
- Scans/Photos of the following:
  - Passport Bio ID page
  - Driver's license
- Your church's address
- Prescription medication information
- Health insurance information
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.

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 all applicants.

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!

*Please send any questions or concerns to ccgfmissions@gmail.com*

Click NEXT to begin your application.

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

First NameMiddle NameLast Name
Date of Birth*

MonthDayYear
Date
Gender*
Social Security #*
Required to perform a background check
T-Shirt Size*
Country applying to serve in?*
Country
What month is this trip?*
How will you be serving?*
Have you been on a short term missions 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?*

Passport Information

A passport is needed to travel on an international mission trip.
Do you have a passport?*

YesIn process of getting one
Application Date

MonthDayYear
Estimated Date of Receiving Passport

MonthDayYear
Other Notes
(Ex: Applied with expedited processing)
Please provide Calvary Chapel Grace Fellowship with a picture of your passport once you have received it.
Passport Number
Issuing Country
Passport Expiration Date

MonthDayYear
Date
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)
Do you have a valid driver's license or permit?*

YesNo
Driver's License Number
Issuing State
Upload Your Driver's License Image

Cancelof

Contact Information
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Cell Phone Number*
Please enter a valid phone number.
Home Phone Number
Please enter a valid phone number.
Work Phone Number
Please enter a valid phone number.
When is the best time to contact you?*

Personal Information
Marital Status*
What is the full name of your spouse/fiancé?
How many years have you been widowed?
How many years have you been divorced?
How many years have you been separated?
If applicable, what is your maiden name?

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 or "none."
List any formal Bible training*
List school name, location, dates, major/minor, degree or hours completed or "none."

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

Street Address

Street Address Line 2

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?
Allergies to pollen, food, medication, or anything else
Please describe any other allergy-related information here.
If none, write "None."
Do you have any chronic medical conditions?*
Please list each medical 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?*
We may request a copy in the case of an emergency

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
Secondary Insurance Group Number
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*
Please enter a valid phone number.
Emergency Contact's Phone #2
Please enter a valid phone number.
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 the Calvary Chapel Grace Fellowship 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 Calvary Grace Fellowship 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 the church and its ministry efforts. (Examples of this include, but are not limited to, website postings, newsprint/magazine ads, newsletters, brochures, postcards, invitations, program covers, outdoor banners, signs, marquee posters, correspondence, informational or promotional videos, and video clips for the website).

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

I hereby further grant permission for Calvary Chapel Grace Fellowship 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 these photos, videos, and audio to Calvary Chapel Grace Fellowship in a timely manner. I understand that Calvary Chapel Grace Fellowship will use the media content that I provide for the same purposes mentioned herein above.

Character References

List two references.
Calvary Chapel Grace Fellowship requires two references. When you submit your application, we will e-mail confidential forms to these two references.
Name of Reference #1*

First NameLast Name
How do you know Reference #1?*
Email of Reference #1*
example@example.com
Phone Reference #1*
Please enter a valid phone number.
Name of Reference #2*

First NameLast Name
How do you know Reference #2?*
Email of Reference #2*
example@example.com
Phone Reference #2*
Please enter a valid phone number.

Background Check - Disclosure and Authorization
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 investigation report, which may include information about your character, general reputation, personal characteristics, and/or mode of living and involve personal interviews with sources such as your neighbors, friends, or associates.

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

NOTE:
- Calvary Chapel Grace Fellowship will need your social security number to conduct this background check.
- You will be responsible for non-refundable $35.00 background check fee.
Have you have completed a background check with Calvary Chapel Grace Fellowship for a past mission trip?*

YesNo
For what mission trip was your last background check?
List mission trip and date (Ex: Costa Rica Nov 2023)
Protect My Ministry Authorization/Consent Form

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 Calvary Chapel Grace Fellowship.
Name*

First NameMiddle NameLast Name
Signature*

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Mission Trip Application

General Information

Passport Information

Driver's License Information

Contact Information

Personal Information

Education Background

Church Information

Your Trip Expectations

Your Christian Beliefs

We'd Like To Know More About You

Ministry Interests, Part 1

Ministry Interests, Part 2

Medical Information

Health Insurance

Emergency Contact

Release Consent of photos, video, and audio

Character References

Nature of the Trip

Background Check - Disclosure and Authorization

Sign & Submit the Application