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Mission Application
Please complete and submit the entire application.
Which WBC Mission Team are you applying for?
2014 Winter Olympic Outreach: Sochi, Russia
Appalachia Regional Ministry
Benevolence Ministry: The Place
California Global Mission Outreach
Friends of Nazareth Vacation Bible School Ministry
Fun in the Son Festival with Andrew Palau: Jamaica
Israel: Christian Bible Land Seminar
London Bridges : July 25-August 2, 2013
Romania: Jewel of Central Europe
The Place : Whitesburg Baptist Church on Pulaski Pike
Zimbabwe: South of The Sahara Mission
Contact Information
Name
Date of Birth
Home Address
City, State & ZIP
Phone Number (please specify home, cell, work or fax)
Church Membership
Email Address
Your Story
Why do you want to participate in this particular short-term mission trip and
what do you hope to see God accomplish through you?
Explain any apprehensions or fears you have about going on a short-term mission trip.
Please briefly describe how you came to trust in Jesus Christ for your salvation.
What has God done in and through you since you became a follower of Christ?
Passport Information
Exact Name on Passport
Passport Number
Citizenship
Issue Date
(MM/DD/YYYY)
Expiration Date
(MM/DD/YYYY)
Birth City
Place Issued
Missions/Cross Cultural Experience
Have you previously served on a WBC Mission Team?
Yes
No
Have you previously participated in a short-term missions project through another organization/church?
Yes
No
List all missions and cross-cultural experience
Emergency Contact Information
Someone not on the same WBC Mission Team
Name
Phone
Email Address
Employment Information
Employer
Position/Job Description
Work Phone Number
Medical Information
Are you currently under the care of a physician or therapist?
Yes
No
If yes, please explain
List all major health conditions and illnesses within the past five years
Describe any medical conditions that require assistance
List all medications taken on a regular basis
Background Information
Have you ever been convicted of a crime?
Excluding minor traffic violations
Yes
No
If yes, please provide details about the incident
References
List 2 references that know your ministry strengths and weaknesses
Reference 1 - Name
Relationship
Phone
Reference 2 - Name
Relationship
Phone
Security Code :
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