Welcome to the 2010 Student Summer Missions Application
Please fill in all of the boxes and double check that all information is correct before submitting this form.(You may hit Tab to select the next box, or Shift+Tab to go back one box)**NOTE: Application takes about 20-30 minutes to complete. You CANNOT begin it, save it and then complete it at another time. Please complete the full application when you can do it in one sitting. Please be ready to input insurance information (if you have it) at the end of the form.
Name of Trip Applying for: select oneWayumiPhillyNYGONew York Next LevelCosta Rica This is my first preference.
Are you applying to be a leader or participant? participantleader
Second (if any) trip applying for: noneWayumiPhillyNYGONew York Next LevelCosta Rica Are you applying to be a leader or participant? noneparticipantleader
I'm applying for this second trip (please choose one): in addition to my first selection
only if my first selection is not available
Personal Information:Your Name:
Age: Grade: (for jr/sr high) Phone: Email:
Are you on Facebook? YesNo If so, what is your Facebook name? Address: Home Church:
Where do you attend school or work?
Parents Name:
Parent's Phone Number: Parent's Email: Are you involved in MPACT this year? YesNo If so, who is your MPACT leader?
Parent's Phone Number: Parent's Email:
Are you involved in MPACT this year? YesNo
If so, who is your MPACT leader?
Please Answer the Following Questions:1a. Are you a Christian? YesNo1b. Tell us about your personal story of how you came to have faith in Christ: 2a. Have you ever had any short term or long term missions experience? YesNo2b. If yes, please explain the trip name, dates, location, and your part on the team. Also, summarize the experience and how it affected you: 3. Why do you want to serve on this team?4a. What are your strengths? How could they help this team? 4b. What are your weaknesses? How could they hinder this team? (Please write at least one weakness)5a. What activities or experiences have helped your spiritual growth in the past year?5b. Are you currently serving in any ministries, either at Calvary or another church? YesNoNot Yet5c. If yes, please briefly explain your involvement and role in the ministry(ies):6. What do you think is the purpose of a Christian in the world today?7. List the names of some books (other than the Bible) you have read which have contributed to your spiritual growth:8. List a verse or a passage of scripture that has significant meaning to your life, and state why: 9. Where would you rate yourself regarding Great Commission service and becoming a world Christian?I am a supporter of other missionaries.I am definitely going to be a missionary.I am open to being a missionary.I have just started thinking about being a missionary.I have never really thought about missionary work.
10. Please rate yourself in the following areas, using your life experience as a comparisson: (5=Great, 1=Needs Improvement)
Relationship to the Lord5 Great4321 Needs Improvement
Respect for Authority5 Great4321 Needs Improvement
Sense of Responsibility5 Great4321 Needs Improvement
Flexibility/Adaptability5 Great4321 Needs Improvement
Sensitivity to Others5 Great4321 Needs Improvement
Servant′s Heart & Attitude5 Great4321 Needs Improvement
Leadership Potential5 Great4321 Needs Improvement
Positive Attitude5 Great4321 Needs Improvement
Ability to Work Hard5 Great4321 Needs Improvement
Ability to get along with Others5 Great4321 Needs Improvement
11. Briefly describe your future plans as best you forsee:
12. Are you currently sharing your faith with any friends or family members? YesNoI have someone in mindI don't feel like I know how
13. Are your parents supportive of your decision to go on this mission trip?select oneYesNoI haven't thought to ask them
14a. Do you have scheduling conflicts that could prevent you from being on this team, participating in all the training meetings, or being part of the auction? select oneYesNoNot sure 14b. If Yes or Not sure, Please explain: Getting to know you. What is your favorite...15. Music Group or Artist? 16. Candy? 17. TV Show? 18. Book of the Bible? 19. Author? 20. Sports Team?
If "yes" please explain:
Do you have any allergy or medication requirements? yesno
Will you be covered by a health insurance program during this trip? yesnoName of Company : Policy #
We ask that a personal contribution/deposit be made to your account by March 26th, our first Missions Training Meeting. For the Wayumi team the contribution is $25; for the Philly team the contribution is $50; for NYGO, C4 NY and DR the contribution is $100.
I (Your Name) , agree that all of the information here is correct. I do, hereby, acknowledge that filling out this form does not guarantee my involvement on any Calvary Mission Trip, but filling out this application does get me one step closer. All information in this form is truthfully and honestly filled out to the best of my knowledge.
I agree to the personal responsibility of funding my trip. I understand that will take place through my own personal contribution, the Student Ministry Auction and asking others for support.Please check here to confirm that you have read this and agree to it:
When finished, please click the submit button below ONLY ONCE, then wait for it to be processed. You will be redirected to a message confirming the submission and directing your next steps. You will be directed to obtain a parent and other adult reference. You will need to email your references a link to the form. Please tell your references what trip(s) you are applying for.
Thank you,
©2010 Calvary Church Student Ministries Team