PERSONAL INFORMATION

Date of Application
Mo / Day / Yr

Title Mr. Mrs. Miss
Mr., Mrs., Miss.

Your Name

Outreach Applying For: 2-3 Week 5-Month

Permanent Address:

Phone Numbers:
Please List Home & Cell

Age:

Birthday:

Birthplace:
City / State/Prov / Country

Sex: Male Female

Email Adress

DEPENDANTS

Names of spouse / children accompanying you:
Please List Last, First, MI Name / Birthdate (mo/day/yr) / Sex / Present Age of each Dependant

LANGUAGES 1. Mother Tongue 2. Full professional proficiency 3. Limited word proficiency 4. Elementary Speaking
Languages: Indicate proficiency on the line below:

English

Other Languages

SKILLS

Occupational skills:

Years/Mo Experience:

Other Talents, Abilities, or Hobbies:

WORK EXPERIENCE

Current Occupation:

Work Phone:

Previous Work Positions:
Please List Dates / Locations & Supervisors for each position held

Do you have any experience working with Christian Missions? If so when/where?:

PASSPORT/VISA INFORMATION

Do You Have a Passport? Yes No

Country of Citizenship:

Passport #:

Name Listed On Passport:

City and Country where Passport Issued:

Passport Expiry Date:

Visa Type/Duration:

Non U.S. Residents:

Date Visa Issued:

Visa Expiration Date:

City and Country where Visa issued:

Have you ever been refused a Visa?: Yes/No (Give nation and details)

EMERGENCY INFORMATION

In case of emergency, contact:
Liste Relationship to Contact

Address of contact:

Phone of Contact:

Email:

PERSONAL EMERGENCY INFORMATION:

Height:

Weight:

Blood Type

Allergies:

Are you taking prescribed medications (Physical or Pscycological)? (If yes, specify) Yes No

CONSENT FOR TREATMENT

In case of an emergency, I/we hereby agree to the performance of such treatment, including anesthesia and/or surgery, as the attending doctor or physician deem necessary.

Applicant's Signature:

Date:

FINANCIAL INFORMATION

Do you have your complete outreach fees? Yes No

If no, from what source will they come?

Do you have any outstanding debts? (If so, please explain)

ACKNOWLEDGEMENT OF FINANCIAL RESPONSIBILITY

I understand that payments for the fees of the trip must be made in U.S. currency prior to or upon arrival, unless other wise approved by Ministry Directors before my departure.

Signature

Date

PERSONAL HISTORY

Please describe your conversion experience and present spiritual relationship with the Lord:

What areas of your character are you presently seeking God to further develop and improve?:

Please describe your spiritual and/or ministry goals, including missionary service goals:

Please describe your relationship with your local church, I.e., areas of ministry, service, leadership experience, gifts, and abilities:

Please describe your business, professional, missions, or other significant experiences:

RELEASE OF LIABILITY

Do You Agree?
I/we do hereby release S.E.N.D. Ministries, its staff, agents, and volunteer assistants from any liability whatsoever arising out of any injury, damage, or loss which may be sustained by said person(s) during the course of involvement with S.E.N.D. Ministries. I understand that travel, particularly for mission purposes, may involve significant risks and that travel to some areas of the world involves greater health and safety risks than foreign travel in general. I understand that it is my sole responsibility to gather whatever information I need in order to assess the risk involved in any travel, stay or other activity contemplated by this RELEASE. My signature on this RELEASE, and my participation in any such activity means that I have to my full satisfaction obtained all information necessary for me to assess the risk and to participate willingly.

Applicant’s Signature:

Date

I certify that all information in this application is complete and accurate.

Applicant’s Signature:

Date:
S.E.N.D. Ministries admits persons of any race, color, national, and ethnic origin to all rights, privileges, programs, and activities generally accorded or made available to persons involved with ministries. It does not discriminate on the basis of race, color, national, and ethnic origin in administration of its policies and programs.

I agree with SEND MINISTRIE'S Statement of Faith

Signature
Statement of Faith can be found in the About Us section of this website.

Date

Commitment to Holiness:

I will Commit
I commit myself before the Lord to keep myself pure in all ways and honor my fellow teammates. I will not involve myself in any physical or emotional relationship with the opposite sex during this outreach, so that I might stay focused on pressing toward the goals of reaching the lost and building up the body of Christ. This also includes refraining from coarse jesting, gossip, instigating and anything else that might stumble my fellow co-laborer, or the people that I am coming to serve. During this outreach, I will refrain from any use of alcohol, drugs, or nicotine that I might keep myself unspotted from the world. I will seek to use my words wisely and let my speech be full of grace that will bring edification to the soul, seeking only to build up, and never to tear down. I will respect the authority of my leaders, acknowledging that they are accountable before the Lord to watch out for my soul. Lastly, I will seek to make my relationship with the Lord my first ministry and priority above all other ministries, friendships, and responsibilities; persevering in daily devotions and quiet times that I might be filled with the Holy Spirit and molded into a vessel of honor mightily used and poured out for the gospel and the building of God’s kingdom.

Signature:

Date:

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