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Servolution Missions Application 2001

Servolution Missions Application 2001

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Published by Dale Schaeffer
Application for our summer mission experience to Louisiana.
Application for our summer mission experience to Louisiana.

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Categories:Types, Research
Published by: Dale Schaeffer on May 24, 2011
Copyright:Attribution Non-commercial

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02/11/2013

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Healing Place ChurchMissions Application Mission Trip Date: July 10-16, 2011 (Travel dates: July 9
th
& July 16
th
) Servolution Informational Meeting: Saturday - June 4
th
– 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
 
Team Information
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.
 
 Legal Information 
Have you ever had a civil or criminal claim against you alleging physical or sexual abuse or sexualharassment? ___ Yes ___ No
 
Have you ever been charged, arrested or convicted of a felony or misdemeanor? ___ Yes ___No
 
Have you ever been terminated from employment or had employment terminated, or has your employer ever reprimanded you for reasons relating to allegations of physical or sexual abuse or sexual harassment? ___ Yes ___ No
 
Have you ever been reprimanded as a student for harassment (sexual or otherwise) or other inappropriatebehavior with another individual? ___ Yes ___ No
 
If you have answered yes to any of the above, please explainbelow._________________________________________________________________________________  ______________________________________________________________________________________  ______________________________________________________________________________________  _____________________________________________________________________________ 
 Missions Information
 
Have you ever been on a mission’s trip before? ___ Yes ___ NoIf so, where and when?____________________________________________________________________________________  ______________________________________________________________________________________  ______________________________________________________________________________________  ______________________________________________________________________________________  ______________________________________________________________________________  Please explain why you want to attend this mission’s trip. ______________________________________________________________________________________  ______________________________________________________________________________________  ______________________________________________________________________________________  ______________________________________________________________________________________  ______________________________________________________________________________________  ______________________________________________________________________________________  ______________________________________________________________________________________  ______________________________________________________________________________________  ____________________________________________________________________ 
 
Financial Information
:
(Please attach a $ 50. deposit with your application). Trip Cost: $ 280 (Includes meals & seven nights of lodging – Meals for travel days are at your own expense)Transportation Cost: $ 150. (Renting 2 – 15 passenger vans & gas)T- Shirts: $ 10 each (you get one free but it must be worn every day).Do you want to purchase additional T-Shirts? ___Yes ___NoT-Shirt Cost: # of Shirts x $10 = $ ____________ Total Cost for Trip: $___________  Will you need assistance in raising your funds? ___Yes ___No Will you be willing to help in any fundraising efforts? ___Yes ___No 
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