CFC Mission Trip Application

General Information

Name (as appears on passport)

This address will receive a confirmation email

Phone

Address

Church Involvement

How long, and in what capacity have you been involved at Christ Fellowship Church?

Motivations and Abilities

Why do you want to go on this trip?

In your opinion, what are your weaknesses?

Global/Cross Cultural Experience

Have you been on a mission trip before?

Yes No

If yes, where and when did you go?

Employment

Please list where you currently work and what you do.

Health

How would you describe the present condition of your health?

Excellent Good Average Poor

Primary Care Physician Name

Primary Care Physician Phone

Please list any current medications you are on:

Emergency Contact

Emergency Contact Name

Emergency Contact Phone

Emergency Contact Email

This address will receive a confirmation email

Basic Commitment

Please check the following that you agree to...

If selected to participate on this mission trip, I commit to the following:

Consent to a background check, if required by my team Participate in the training process before, during and after my trip Conduct myself in a manner worthy of the Lord while serving on the trip Submit to the authority of the team leader on the field and to all team policies Be responsible for the cost of my airline ticket if I have to withdraw from the trip after the tickets have been purchased Adhere to team funding policies and deadlines Confer with a health care professional concerning the vaccines/immunizations required for my trip

Electronic Signature

Deposit $25

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

CFC Mission Trip Application

Description

Please Fix the Following