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- Are you a*
- If you are applying for an international trip - do you currently have a passport? (Note: Passport information is required to purchase airline tickets)*
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Format: (000) 000-0000.
- Date of Birth*
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Format: (000) 000-0000.
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Format: (000) 000-0000.
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- Do you live with both parents?
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Format: (000) 000-0000.
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- 2. Do you speak any foreign languages?*
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- 3. Do you hold dual citizenship?*
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- 1. Are you in good physical health?*
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- 2. Do you have any physical handicaps?*
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- 3. Will you be willing to eat whatever food you are served?*
- 4. Do you have any known allergies, including food or medical?*
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- 5. Are you currently taking any medications?*
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- 1. Have you confessed Jesus Christ as your Lord and Savior?*
- 2. Have you been baptized in water?*
- 3. Have you been baptized in in the Holy Spirit?*
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- 1. Have you ever participated in an AIM outreach?*
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- Date*
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- Date
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- Should be Empty: