Japan

Korea

Russia

India

 

 

Application Form

Last Name:
First Name:
Date of Birth:	12345678910111213141516171819202122232425262728293031  Day JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember  Month 19001901190219031904190519061907190819091910191119121913191419151916191719181919192019211922192319241925192619271928192919301931193219331934193519361937193819391940194119421943194419451946194719481949195019511952195319541955195619571958195919601961196219631964196519661967196819691970197119721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000  Year
Street Address:
Address (cont.):
City:
State/Province:
Zip/Postal Code:
Country:
Work Phone:
Home Phone:
Fax:
Cellular:
E-mail:
Passport Expiry Date:	12345678910111213141516171819202122232425262728293031  Day JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember  Month 200020012002200320042005200620072008200920102011201220132014201520162017201820192020202120222023202420252026202720282029203020312032203320342035203620372038203920402041204220432044204520462047204820492050  Year
Passport Country:
Pastor's Name:
Pastor's telephone:
Have you accepted Jesus Christ as your personal Lord and Saviour?	Select OneYesNo
Church Name:
Construction Licenses:
Work History/Skills:
Are you willing and able to work high off the ground?	Select OneYesNo
Are you willing and able to work long days?	Select OneYesNo
Work Refernces:
Christian References:
Your spouse's name:
Does your family support your participation in this project?	Select OneYesNo
What is your motivation for joining this short term mission team?
What can you bring to the team?
When are you available to start?	12345678910111213141516171819202122232425262728293031  Day JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember  Month 200020012002200320042005200620072008200920102011201220132014201520162017201820192020202120222023202420252026202720282029203020312032203320342035203620372038203920402041204220432044204520462047204820492050  Year
How many weeks?	Select One234More
Do you have mission experience?	Select OneYesNo
If yes, where?
Nearest International airport:
State of your health:	Select OneExcellentGoodLimited
If you choose limited explain
Do you have a criminal record?	Select OneYesNo
Are you willing to participate in this project without using alcohol or any banned drugs?	Select OneYesNo
Emergency Contact
Please provide a short Christian Testimony about yourself: