MISSION APPLICATION

Personal Information

First name

Last name

Cell Phone

T-shirt size

Marital Information

Marital status

Spouse's name

Number of children

Passport Information

Name as it appears on the passport

Passport number

Date issue

Expire date

Country of birth

Country of citizenship

Emergency Contact Information

Contact name

Relationship

Phone

Health Information

How would you describe your current health?

List any medical conditions (past & present)

List all known allergies (medicines, foods, etc.)

List of current medications

Health Insurance

Policy Number

Phone

Occupation Questionare

Current place of employment

Title

Describe your job duties and how it may help on this event

Personality Profile

Describe your character strengths

Describe your character weaknesses

Describe how you think others view you

Personal Information

Briefly describe the most significant event in your life in the past 2 years

Are you in a relationship with anyone on this event?

Have you been convicted of committing a crime? If convicted, describe

Motivation Questionare

Why do you want to attend this event?

What are your event expectations?

Spiritual Life Questionare

What church do you attend or is a member of?

Have you ever served in a ministry in your church? If so, describe

Have you ever served in a volunteer or leadership role outside of the church? If so, describe

Describe your recent quiet times with God

Who is Jesus to you?

Special Abilities, Talents, & Missions Experience

Rate your skill level next to each potential job/need

Carpentry

Masonry

Electrical

Painting

Roofing

Plumbing

Nursing

Dental

Therapy

Physician

EMT/first aid

Photography

Journaling

Juggling

Puppetry

Clowning

Sewing

Music

Cooking

Cleaning

Sports

Coaching

Organizing

Teaching

Listening

Other abilities

List all the foreign languages you speak or are proficiency

List previous mission trip experience, locations, church/organization, & date of each trip

Commitment Contract

If selected to be a part of GTD's short term mission trip, I make the commitment to (enter "yes" or "no" in each box below)

Faithfully go through the training process prior to departure and after I return from the trip

Raise the necessary prayer and financial support

Submit to the GTD Leader's & Missionary Host's authority

Conduct myself in a manner worthy of our Lord while refraining from any behavior which may compromise my witness

Applicant's Name or Signature

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Additional Requirements

Either scan (or make 3 color photocopies of) the following items and email to the address: info@goingthedistance.org

Drivers license (or student id if under 16)
Passport (as soon as it's available)

Character references

Each applicant is required to provide 3 character references. At least 2 references are to be non-family members such as a pastor, spiritual mentor, Bible study leader, small group leader, accountabilty partner, etc.

They should be people that know you well and can answer questions about your spiritual maturity.

List your 3 references here along with their relationship to you and their phone number.

In addition, either email, mail or deliver the Character Reference Form (see website) to each of your 3 references.

Reference 01

Reference 02

Reference 03

Feedback

Please let us know if you have any additional questions, comments, feedback, or requests.