short term mission trip application << previous page
Please complete this form to apply for one of our Short Term Mission Trips

I. Applicant Information

Trip You are Applying for:
Applicant Name:
Address:
City: State: Zip:
Gender: Birth Date:
Day Phone #: ( ) - Evening Phone #: ( ) -
Cell Phone#: ( ) -
E-mail:
Spouse Name:
Parent/Guardian Name: (If applicant is a minor)
Name and Age of Children:
General Health Condition:
Describe any Physical Limitations:
Current Passport? If Yes, Passport Number & Expiration Date:
NHC Member?

II. Emergency & Medical Information

Emergency Contact Name: Emergency Contact #: ( ) -
Insurance Company Name: Policy Number:

III. Personal Information

Have you traveled outside the United States?
If yes, please describe where and when you traveled:
Describe any previous cross cultural experiences you have had:
Describe the ministry and goals you would like to accomplish on this trip:
Briefly state your testimony and describe your Christian journey:
Have you been instrumental in leading anyone to Christ?
If so, describe how you did that:
What prompted you to apply for this trip?
What experiences have you had working in a local church or Christian ministry organization?
Describe your spiritual gift(s).

Language Skills

List any foreign languages studied:
Are you proficient in using the language?
Speaking
Writing
Reading

I am comfortable serving in the following areas of ministry:

Children’s Ministry Sharing my testimony
Youth Ministry Reporter/Setup website/Blog
Puppet show Sports Ministry
Organizing/Leading singing & worship Other:
Conversational English ministry Other:

Please check any talents that you have:

Children’s Ministry Team Leader
Playing a musical instrument Photographer
Drama Videographer
Construction Sports
Medical/Dental Other:
Teaching Other:
List any special skills you feel could be used on this trip:
Are you a member of a mission organization?
If yes, please enter the name of the organization: