Project location: *
Dates: *
Team Leader: *
Project Champion: *
Name: *
Gender: * Male Female
Address: *
City: *
State: *
Zip: *
Home Phone: *
Cell Phone: *
Email: *
Date of Birth: *
Country of Birth: *
Yes
No
T-Shirt Size: * Youth Small Youth Medium Youth Large Small Medium Large X Large XX Large
Marital Status: * Single Married Divorced Widowed Separated
Spouse's Name:
Is your spouse supportive of your participation in this project? *
Name as it appears on your passport: *
(If you have applied for a passport, please write your name as it will appear on passport).
Passport Number: *
Expiration Date: *
Name of Insurance Company: *
Policy Number: *
How would you describe your present health? * Excellent Good Average Poor
Please state any major illness(es) you have had in the last five years: *
If yes, please explain:
Please list any medications you are currently taking:
Please list any allergies you have:
Emergency Contact: *
Relationship to Participant: *
Emergency Contact's Home Phone: *
Emergency Contact's Cell Phone: *
Church Membership: * Burnt Hickory Baptist Church Other Church
Other Church Membership:
How long have you been a member?
Are you an active member of a Life Group or Sunday School class?
Name of your leader:
How long have you been in that group or class?
Please list any responsibilities in Life Group or Sunday School leadership you have:
If yes, please describe your experience:
What are you spiritual gifts?
How do you think you might be able to use your gifts on this trip?
Have you had training in personal evangelism? If so, please explain:
When was the last time you witnessed to someone one-on-one?
List the ministries with which you have been involved at your church, including time of involvement with any leadership positions held:
How would you describe your daily relationship with Christ? *
List the ministries you have been involved with outside of your church, including any leadership positions held:
If you have been on a BHBC InsideOUT mission project within the last two years and your testimony has not changed, check the corresponding box and just write the location and dates of the project you participated in.
I have been on a BHBC InsideOUT mission project within the last two years and my testimony has not changed.
Location and dates of past mission project:
How was your life before coming to Jesus? *
How and when did you know Jesus as your Savior? *
How is your life now that you know him? *
Briefly describe why you see God calling you to participate in this trip: *
What gifts or talents do you have that you would like to use on this trip? *
What do you see as your role on this ministry team? *
