Phone number
Phone type Mobile Home Work Other
Marital status
Select… Single Married Engaged Widowed
Which partnership are you applying to visit? *
Emergency Contact Name, Address, and Phone Number *
Do you regularly attend Providence?
Select… Yes No
Do you have health insurance? *
Select… Yes No
How would you describe your current health? *
Select… Excellent Good Average Poor Other
Do you have any physical limitations? *
Current medications you're taking:
Please list any allergies you have:
How do you plan to finance this trip? *
Have you ever been involved with illegal drugs? *
If yes, please explain:
Do you have a record of criminal offense in any country? *
If yes, please explain:
How and when did you become a Christian? *
Please give an overview of your growth in Christ: *
Describe your devotional life: *
In your own words, please give an explanation of the Gospel. *
Why do you want to serve on this team? *
What, if any, cross-cultural experiences do you have?
Do you have any special interests or talents that you would like to share?
Do you agree with and affirm Providence Church's core values and beliefs? If no, please give an explination. *
https://providencewc.org/about-us/core-beliefs--values/
As part of the screening process for participation in a short-term mission trip, applicants (if needed) may be required to undergo a background check, which includes fingerprinting. The cost of fingerprinting and the background check is the responsibility of the applicant. By submitting this application, you acknowledge and agree to comply with this requirement. I authorize Providence Church or its mission partners to review the results of criminal background check and/or fingerprints. Note: failure to check "Yes" will result in your application being denied for acceptance.
We will be meeting together as a team approximately 4 times before our time in-country and 2 times post-trip to learn in-depth about how to engage in healthy ministry both abroad and at home. Missions trip team leader will be leading these trainings. I understand that these meetings are mandatory and a very important part of the entire experience. I commit to attending the meetings and completing any outside homework needed.
In consideration of the benefits derived from my participation in this missions trip with Providence Church or one of its missions partners, I do hereby voluntarily release, acquit, and forever discharge the church and its directors, officers, employees, missions partners and agents from all manner of suits, actions, claims, demands, and liabilities which may arise from my participation in the trip. I recognize that the conditions in some of the places to which I travel are not the same standards as the conditions to which I am accustomed (I.e., political environments and judicial systems). I realize further that there are certain health and detainment risks as well as other risks to my property and me, and I enter into participation in this trip with knowledge of those risks. I understand that this document constitutes a full and complete waiver of all possible claims, including claims for negligence in personal injury or property damage, arising out of my participation on this trip. No provision of this document shall, in any way, limit my right to make claims against persons other than the church, its director, officers, employees, missions partners and agents. I understand that by signing this release/disclaimer that I am bound to the contents therein.
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