Mission Team Application

Followers Church partners with Fundacion La Mision, a Guatemalan mission organization demonstrating the love of Jesus by meeting the physical needs of the most underserved in their country. We will set up mobile medical clinics in remote jungle villages near Puerto Barrios, Guatemala. The climate in this area is hot, humid and often rainy (with the humidity, the 'feels like' temps can reach 120 degrees Fahrenheit and higher). Accomodations include shared rooms in a private home in Guatemala City and hotel in Puerto Barrios. Transportation between Guatemala City and Puerto Barrios will be in a 13-passenger van for approx. 6-8 hours. Transportation from the hotel to the villages is generally standing or sitting in the bed of a pickup truck for 30 min-2+ hrs. Clinic setup/teardown may require lifting/carrying heavy or bulky equipment for several yards over muddy, uneven ground.

Dates: Thursday, August 8th - Monday, August 19th, 2019 (12 days)

Cost: $2500-$3000 (actual cost varies depending on number of team members, fundraising efforts, airfare cost fluctuations, etc.). This includes airfare, room/board, meals while in country (airport meals are on your own), travel insurance, any pre-trip training materials, transportation while in country, clinic costs/supplies, and more.

Sample itinerary (subject to change):

Day 1 - air travel to Guatemala (approx. 4am - 9pm)
Day 2 - sightseeing
Day 3 - road travel (by van, 6-8 hrs)
Days 4-6 - medical clinics, kids activies, water filters
Day 7 - visit Sarita school to learn about sponsorship program, play with kids, various improvment projects
Days 8-9 - medical clnics, kids activities, water filters
Day 10 - additional day of clinics or "fun day" (varies year-to-year)
Day 11 - road travel (by van, 6-8 hrs)
Day 12 - air travel home (approx. 2-3am to 8-9pm)

Time Commitment: team will meet 1-2 times/month leading up to the trip for training, cost updates, fellowship, etc. Meetings are usually 1-2 hours.

Skills required: just be willing to learn - every job in the clinics is teachable; no medical experience is required

Other requirements: team members are expected to

be relationally, functionally and financially invested in their home church community
participate in pre-trip meetings, prayer events, and the final packing party
be able to fully participate in all activities while in country
be able to give up certain comforts of home, including food preferences, tobacco, alcohol, clothing preferences, and more, willingly and without complaint
if traveling with a spouse, be willing to sleep separately for the duration of the trip (men and women sleep in separate rooms for both cost and space efficiency)

PERSONAL INFORMATION

Today's Date: *

Date

Name

First Name Last Name

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Mobile Phone: *

- Area Code Phone Number

Mobile Phone Carrier: *

E-Mail Address: *

example@example.com

Date of Birth: *

Date

Occupation: *

Employer or School: *

Relationship Status *

Single Married

If single, are you currently in a relationship with another applicant?

Yes No

If yes, please provide his or her name:

Spouse's name (if married)?

Does your spouse plan to apply for the team?

Yes No

Does your spouse support your participation on the team?

Yes No

If your spouse does NOT support your participation, please provide a brief explanation:

Do you have a valid passport? *

Yes No

MINISTRY EXPERIENCE & SKILLS

Please indicate any areas you've served in the past 12 months or are currently serving:

Please describe any additional volunteer or community service experience: *

Explain a little about what prompted you to serve in the areas described above?

Please describe any skills or work experience you have that may be relevant (teaching, construction, medicine, art, administration, etc.): *

Do you speak a foreign language? *

Yes No

Please list:

What level of proficiency?

SPIRITUAL LIFE & MINISTRY INVOLVEMENT

Where do you attend church? *

I am a member: *

I am a regular attendee: *

Have you attended a membership class? *

Briefly describe the circumstances in which you became a Christ-follower: *

What prompted you to apply for this trip? *

Have participated in short term missions before? *

Yes No

If yes, please describe your experience and be sure to include specific details such as dates, locations, and tasks performed.

How did this mission impact you or your relationship with Christ and others? Describe how your life changed once returning home?

How would you describe your involvement in the following areas?

Daily prayer and devotional time? *

Attending or watching weekly services? *

Discipleship - attending classes, participating in Life Groups, etc.? *

Supporting your church financially through personal tithes and offerings? *

Serving your church as a volunteer? *

STATEMENT OF HEALTH

Are you currently under the care of a physician or taking prescription medication? *

Yes No

If you are currently taking a prescription medication, will you be bringing it on the trip? *

Yes No

There may be regulations around carrying certain medications through international customs. You are responsible for ensuring you have enough medication to last the duration of the trip as well as ensuring the medication is packed and transported according to TSA and customs regulations.

Team members need to be able to handle the physical demands of the trip which include: extreme heat/humidity, sitting for long periods (6-12 hours), lifting or carrying heavy equipment, standing for long periods, eating foreign foods, sharing rooms, limited privacy/personal space, riding in the backs of pickup trucks, and more. Do you have any limiting physical conditions which could hinder the safety or efficiency of you or the team? *

Yes No

If yes, please list:

The Zika virus and other mosquito-born illnesses may be locally transmitted in Guatemala. Zika is usually mild with flu-like symptoms lasting from several days to a week. Hospitization is extremely rare, however, if you or someone in your immediate family is pregnant or plans on getting pregnant, please be aware that there could be a significant risk of birth defects or poor outcomes for the baby. Visit www.cdc.gov for further information.

I have read this disclosure about the risks associated with the Zika virus and other illnesses and hold this church and all other affiliated mission agencies harmless.

Initials *

I have read and agree to the above statement

If selected for the team, I will provide the following medical information to be used in the event of a medical emergency: Physician's contact information, Health Insurance information, and a current and accurate list of all prescription medications.

Initials *

I have read and agree to the above statement

REFERENCES

Please provide 2 references – one personal (i.e. close friend, co-worker) and one spiritual / professional (i.e. mentor, employer, pastor, ministry leader). If you do not currently attend Followers Church, at least one reference must be a pastor at your church (not required for returning team members).

Personal Reference:

Relationship: *

Name: *

Primary Phone: *

E-mail Address *

Spiritual/Professional Reference:

Relationship *

Name: *

Primary Phone *

E-Mail Address *

COMMITMENT AGREEMENT

If selected, be prepared to have fun, work hard, promote unity, and to love and live like Jesus. Please carefully read and consider the statments below. If you are willing to accept and commit to these expectations, initial where indicated.

I understand that per IRS regulations and church policy, ALL contributions from ANY party (myself or others) on my behalf are non-refundable regardless of the reason for cancellation. All mission donations remain in an account for use by Followers Church, or Easpoint Church, for mission projects.

Initials *

I have read and agree to the above statement

I am willing and able to raise the funds needed to cover the cost of this trip.

Initials *

I have read and agree to the above statement

I understand that, upon notification of acceptance to the team, a $250 non-refundable deposit will be due within 30 days to reserve my spot on the team.

Initials *

I have read and agree to the above statement

I understand that I am responsible for obtaining the proper documentation (valid passport) and all required immunizations before traveling. These will be paid for by me. Any required immunizations will be communicated to me prior to travel.

Initials *

I have read and agree to the above statement

I commit to follow the standards of conduct expected of all Followers Church volunteers and staff, to submit to the authority of the team leader(s) and to follow all team policies.

Initials *

I have read and agree to the above statement

I commit to follow the standards of conduct expected of all Followers Church volunteers and staff, to submit to the authority of the team leader(s) and to follow all team policies.

Initials *

I have read and agree to the above statement

While in country, I agree to submit to the leadership of our host(s) and to follow any additional rules and guidelines established for our and their safety as well as the preservation of relationships with the communities we will serve.

Initials *

I have read and agree to the above statement

I understand that if, at any time while in country, my behavior constitutes a problem, the team leader, host and/or any Followers Church leadership have the authority to require me to return home. Any expense incurred on my behalf as a result to this action will be covered by me.

Initials *

I have read and agree to the above statement

I commit to fully participate in all pre-trip and post-trip training, team-building and team-fund-raising activities. Exceptions will be handled on a case-by-case basis.

Initials *

I have read and agree to the above statement

I am willing and able to give up certain comforts of home and live sacrificially while in country (including, but not limited to, use of tobacco, alcohol, food preferences, living conditions, clothing preferences, etc.).

Initials *

I have read and agree to the above statement

I commit to learning and living out the vision of our Mission Team. We are a hard-working, joyful and united team. Our mission is to build and strengthen relationships with Christ, with each other, with our community, and to share the love of Jesus.

Initials *

I have read and agree to the above statement

If accepted to the team, I agree to provide all personal information required to successfully complete a background check.

Initials *

I have read and agree to the above statement

I hereby certify that the information on this form is correct and I understand that any mission trip includes an inherent level of explicit and implicit risk. Travel accidents, loss of personal property, sickness and injuries are among these risks. I knowingly accept the risks of participation in this mission trip.

Please select one of the following: *

Adults 18 & over: *

Applicant's Full Name

Under 18:

Parent/Guardian's Full Name, Phone Number

Final Comments or Questions:

(Optional)

Guatemala 2019