CAMBODIA MISSION TRIP APPLICATION

Please provide all requested information.

Full Names *
Full Names
Please put all full names, as appears on your passport
Contact
Contact Information
Contact Information
Personal Data
Date of birth *
Date of birth
Gender
Marital status
Children
Citizenship
Valid passport? *
Health Info
What is your level of general physical health? *
What is your level of general mental health? *
Emergency Contact
Please give name, relationship, daytime phone number and mobile number
Please give name, relationship, daytime phone number and mobile number
CHRISTIAN EXPERIENCE AND CHURCH INVOLVEMENT
I've been attending my church for *
I attend my church’s services/activities
Please separate with commas
CROSS-CULTURAL EXPERIENCE
Have you ever travelled overseas?
SENSE OF PURPOSE AND CALLING
FINANCES
The estimated cost for the trip is $3000-$4000. How do you plan to finance this? *
In the event you were not able to raise the money needed, please tick one of the following *
DISCLOSURE
Personal declaration *
Date
Date