Healing Place ChurchMissions Application Mission Trip Date: July 10-16, 2011 (Travel dates: July 9
& July 16
) Servolution Informational Meeting: Saturday - June 4
– 9 a.m. – BridgeWay Ministry Center General Information
Name: _______________________________________ I am: __Male __ Female Address: ________________________________________________________ City, State, Zip: ____________________________________________________ Birthday: _____Month ______Day _______Year________ Are you under the age of 18? ___Yes ___No Are you married? ___Yes ___No Will your spouse be coming as well? ___Yes ___No
Please specify any special skills / ministries that you are gifted in:(i.e. electrical, painting, carpentry, drama, dance, face painting, balloon sculpturing, clowning, etc.) Do you require special assistance? If so, please explain: Can you bring any donated supplies? ___ Yes or ___No(Suggested supplies: sample sized toiletries, disposable gloves, trash bags, paint brushes, etc.) If so, please give details below.