Global Outreach Application
Personal Information
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Birthdate
*
-
Month
-
Day
Year
Date
T-Shirt Size
*
Please Select
X-Small
Small
Medium
Large
X-Large
XX-Large
Primary Emergency Contact
*
First Name
Last Name
Relationship
*
Please Select
mother
father
spouse
brother
sister
grandmother
grandfather
uncle
aunt
daughter
son
friend
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
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Passport
Do you have a passport?
*
Yes, I already have one.
No, I am needing to get one.
Exact Name as it Appears on your Passport:
First Name
Middle Name
Last Name
Passport Issue Date:
-
Month
-
Day
Year
Date
Passport Expiration Date:
-
Month
-
Day
Year
Date
Passport Number:
Passport Issuing Country
Please Select
Please upload a copy of your passport here:
Browse Files
Drag and drop files here
Choose a file
Cancel
of
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Health & Wellness Questions
This trip will require lots of travel, physical labor, and long days. Please list any physical or mental health conditions that may pose a challenge to you on this trip. Your answers will enable your group leaders to care for you well on this trip.
*
Do you have any dietary restrictions or allergies?
*
If you do not, type "N/A".
Are there any medications we should know about?
*
If none, type "N/A".
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How long have you been attending Christ Church Anglican?
*
Which congregation do you attend?
*
Please Select
Mission
Overland Park
Which trip are you interested in attending?
*
Please Select
Honduras - Student Life (July)
Honduras (September 2026)
Uganda (August 2026)
How did you hear about this trip?
*
Please choose an option below that best describes your plan to fund the trip.
Please Select
I will pay for the whole trip myself.
I will pay a portion myself and fundraise the remainder.
I will pay a portion and would like to apply for scholarship
How have your experiences serving others prepared you for this trip?
*
What skills, gifts, and abilities do you bring to the team that would be helpful to our team and/or our partners?
*
Please describe your faith and where you're currently at with God.
*
Any other considerations we should know about?
Submit
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