Missions Trip Application

Missions and Ministry Trip Form
Todays Date

MonthDayYear
Date
Select the option that best applies to you:
Personal Info
Your Name

First NameLast Name
E-mail
Phone Number

Area CodePhone Number
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Date of Birth

MonthDayYear
Date
Passport Number
If traveling internationally
Passport place of issue
If traveling internationally
Passport Expiration Date

MonthDayYear
If traveling internationally
Mission Organization
Name of Group/Organization You're Traveling with
Organization/ Emergency Contact

First NameLast Name
Phone Number

Area CodePhone Number
Location of Organization (Address)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
About you
How long have you been regularly attending Life Church?
Why do you desire to go on this specific trip? What is the goal/purpose of this trip?
How are you anticipating this trip will impact your relationship with God? (Or, how will it impact the ministry you lead?)
How will your involvement strengthen the trip?
What positive affect do you expect the team/you will have during or because of this trip?
Trip Info
What is the goal/purpose of this trip?
Describe the ministry/organization you're partnering with (attach information or web address):
Provide names of anyone traveling with you from Life Church (if any that you know of):
Trip start date:

MonthDayYear
Date
Date of conclusion/return:

MonthDayYear
Date
Trip locations (if more than one place):
List any specific outreach ministry activities attached to this trip:
List your current needs (besides funds) i.e.: materials, prayer coverage, team members)
Total cost of the trip:
Trip Budget Breakdown
- Do you plan to use Ministry budget funds for this trip/event?
- Estimated number of participants:
- Cost per person:
- Estimated total income:
- Supplies:
- Food:
- Facility Expense (if renting event space):
- Lodging:
- Travel:
- Scholarship/Financial assistance budget (if any):
- List any miscellaneous costs (guest speaker, t-shirts, gifts, etc.)
- Miscellaneous expense total:
- Total Expense:
- Estimated net (+/-):
- Total cost of the trip
- Latest date to receive funds by:
  
  MonthDayYear
  Date
- List the ways you have sought help to fill any of the needs so far (i.e. fundraisers, support letters, etc.)
- References
- Reference (non- family member)
  
  First NameLast Name
- Phone Number
  
  Area CodePhone Number
- Mentor and/or Pastor
  
  First NameLast Name
- Phone Number
  
  Area CodePhone Number
Should be Empty:

Missions and Ministry Trip Form

Personal Info

Mission Organization

About you

Trip Info

Trip Budget Breakdown

References