Mission Team Application

Mission Team Application
Application
Please submin a $100.00 deposit. Payment can be made using a tithe envolope (cash, check or Credit card), online giving at Gainesville.church (Missions), Text To Give (key word: Trip) or throught the kiosk in the Church Foyer (Missions)
Please submin a $100.00 deposit. Payment can be made using a tithe envolope (cash, check or Credit card), online giving at Gainesville.church (Missions), Text To Give (key word: Trip) or throught the kiosk in the Church Foyer (Missions)
Please submin a $200.00 deposit. Payment can be made using a tithe envolope (cash, check or Credit card), online giving at Gainesville.church (Missions), Text To Give (key word: Trip) or throught the kiosk in the Church Foyer (Missions)
Your Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Birth*

MonthDayYear
Date
Place of Birth
Marital Status

SingleMarriedType option 3Type option 4
Phone Number

Area CodePhone Number
Your E-mail Address*
Place of Employment
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
In the Event of Emergancy , notify
Name*

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
Do you have a current passport?*

YesNo
Passport number
Are you a U.S. citizen? If not, list Country of citizenship:*
Do you have any medical restrictions or handicaps that we need to make provision for?*

YesNo
If Yes, explain:
Are you taking any medication?*

YesNo
If Yes, explain:
Health Insurance Company:
Policy Number:
Will your plan cover outside the U.S.?
What current Inoculation do you have?
Physician Name:
Phone Number

Area CodePhone Number
SKILLS
Please list any skills you have in languages other than English.
Check any of the skills below that apply to you. Give further explanation if necessary.

MedicalDoctorNurseDentalNutritionConstructionCarpentryMasonryPlumbingElectricalOther
Personal Ministry

Bible Study LeaderEvangaelismSingingMusical InstrumentTestimonyPuppetryDramaChildren's MinistryIntercesory PrayerOther
Personal Profile
Are you a christian?*
How Long?
Please answer these questions to the best of your ability
Why do you want to be on this mission team?*
What short-term team(S)have you been on before and what impact did it have on you? Good or Bad? Please explain.
What realistic road blocks might keep you from going on this short term mission trip?
I have answered these questions honestly and sincrely to the best of my ability. I realize that by signing this application and submitting my deposite I am committied to the full financial obligation of this mission trip and all donations received towards are donations to Gainesville Church Of God and are non-refundable.

I also cummit to attend all mission trip meetings

All infformatioin in this apllication is confidential and will be used by team leadership only.
Signature*

Clear
Date*

MonthDayYear
Date
Should be Empty:

Mission Team Application

SKILLS

Personal Profile