Gregurich Ministries Mission Trip Application
Basic Information
Name
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First Name
Last Name
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Birthday
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Month
-
Day
Year
Date
Email
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example@example.com
Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Trip Information
What country are you interested in taking a mission trip in?
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Brazil
Kenya
Please indicate the length of trip you wish to make:
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1 Week
2 Weeks
3 Weeks
1 Month
6 Weeks
2 Months
Other
Proposed dates of trip:
Please give your reason(s) for wanting to go on a mission trip:
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Spiritual History
Are you a Rhema Bible Training College graduate?
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Yes
No
Currently Enrolled
If yes, what year? Any specific area of study?
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Are you born-again?
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Yes
No
When were you born-again?
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Are you filled with the Holy Spirit according to the Acts 2:4 experience?
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Yes
No
When were you Spirit-filled?
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Ministry Experience
Please give detailed information concerning your ministry experience (teaching, youth, children's, music, etc...)
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Please indicate any prior missions experience - include all countries and dates:
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Please indicate which area(s) of ministry you are interested in serving in on this trip:
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Teaching/Preaching
Street Evangelism
Children/Youth
Music
Multimedia
Other
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Finances
Costs vary by trip
How do you plan to finance this mission trip?
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What finances do you have saved for the trip?
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Do you have any pledges for the trip?
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Church Information
Church Name
*
Church Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Who is your Pastor?
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How long have you attended this church?
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List any areas of involvement you've had at your church, when and how long you've served in that area.
*
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Personal History
Have you ever been convicted of a felony? If yes, please explain:
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Have you ever been accused of child abuse of any kind? If yes, please explain:
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Have you ever been accused of spousal abuse of any kind? If yes, please explain:
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Do you have any physical limitations? If yes, please explain:
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Do you have or have you ever had any of the following?
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Diabetes
Major Dietary Restrictions
Repiratory Problems
Heat Stroke
Psychiatric Care
None of the Above
Any other health issues not specifically listed?
*
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Pastoral Letter of Recommendation
What is your Pastor's name?
First Name
Last Name
Your Pastor's email?
example@example.com
Pastor's Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Pastor's Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
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Passport Information
Please note: you must have at least 6 months left on your current passport to travel on a mission trip with Gregurich Ministries.
Full name as it appears on passport:
Passport Number
Issue Date:
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Month
-
Day
Year
Date
Expiration Date:
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Month
-
Day
Year
Date
Do you have any other comments or questions?
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