Note: This application will be used as a tool by the CC-Boise Elders and Missions Board to help you facilitate your call to long-term missions. No answer to any question or questions will automatically disqualify you from involvement. Our earnest desire is to help you work through your call to maximize your effectiveness on the field and at home.

First name

Middle

Last

Spouse's Name (if applicable)

Address

City, State, Zip

Phone (including area code)

(               )                -

E-mail

Date of Birth

Spouse's Date of Birth

Birthplace

Spouse's Birthplace

Citizenship

Spouse's Citizenship

Passport #

Expiration

Spouse's Passport #

Expiration

Current D. L. #

State

Type

SSN #

Spouse's SSN #

Country(s) you will be ministering in (list):

List name, age, and sex of any children accompanying you (if any):

How do you plan to meet the educational needs of your children?

What church/fellowship do you attend?

How long have you been going there?

Describe your relationship with the local fellowship, including areas of ministry and leadership:

Please list the names, addresses, and phone numbers of three references:

1)
2)
3)

Describe any formal (or other) Bible training you have received:

List any musical or other talents/experience which may be useful for this ministry:

Why do you desire to do this and what do you hope to accomplish?

What are your plans upon completion of this missions trip?

Have you had any other missions or cross-cultural experiences? Please describe.

How would you describe your relationship with your family? Include how they feel about your plans for this mission trip.

Missions opportunities often involve challenging circumstances. Our concern is that you not be put in a place where you might stumble or stumble others. Please indicate if you think you may have difficulty dealing with any of the following areas:

Alcohol______ Tobacco_______ Nonprescription drugs_______Gambling_______ Occult involvement_______

Pornography_______ Heterosexual promiscuity______ Homosexual promiscuity_______

Please explain:

Have you ever been involved in a felonious crime? Yes___ No____ If yes, please explain:

Do you have any health problems involving dietary restrictions, medical needs, or any other unique needs we should be aware of? Yes____ No_____ If yes, please explain:

What foreign language(s) do you speak? (Explain degree of fluency)

Using the information from your Financial Worksheet in the missions packet, please answer the following questions to the best of your ability:

How much of the estimated "up-front" cost of your trip do you currently have?

What percentage is this of the total needed?

From what source(s) will you receive the remainder?

Do you have any outstanding debts? Yes______ No______ If yes, please explain.

Occupational

Present Employer

Occupation

How long have you been at your present position?

Please give a brief job history of employers during past five years, along with other occupational skills, if other than listed above:

Insurance

Do you have medical and/or other insurance that will cover you outside the U.S., and does your "Personal Administrator" have all necessary information regarding this? Yes________ No________

Testimony

(On a separate, attached sheet, please share your testimony of how you came to a saving faith in Christ.)

Signature of Applicant

Date of Application

(Form updated 10/28/2001)