Short Term Missions Application

All fields are required. After entering information below, click the Submit button
at the bottom of the page to continue.

Application Trip Details

Trip Name:

Date of Trip:

Personal Information

First Name:

Last Name:

Address:

City:

State:

Zip:

Home Phone Number:

(use this format: 703-555-1212)

Cell Phone Number:

(use this format: 703-555-1212)

Email:

Age:

T-Shirt Size:

Do you have a passport?

Yes No

Expiration Date:

Date of Birth:

Background Information

Have you ever been involved in a missions endeavor?

Yes No

If yes, please briefly describe your experience. Include information about where, when, how long and with whom.

Why do you want to go on this missions trip?

Do you attend IBC?

Yes No

How Long?

Are you a member of IBC?

Yes No

If not, which church do you attend?

*If you checked Foreign Languages, Medical, or musical instruments, please provide specifics below:

Have you ever traveled or lived in a different culture?
Please explain.

Emergency Contact

Name:

Relationship:

Home Phone Number:

(use this format: 703-555-1212)

Cell Phone Number:

(use this format: 703-555-1212)

Email:

Additional Information

Please type a summary of how and when you received Jesus Christ and some of your life experiences as a Christian.

Please provide the name and contact information of one elder or pastor who would be willing to provide a reference supporting your involvement in the mission project (Note: we will send them a form to complete).

Name:

Position:

Phone Number:

(use this format: 703-555-1212)

Email:

Affirmations

(Please initial after each section indicating that you agree with and will support IBC’s Short Term Outreach and Mission Project guidelines and goals.)

I am a believer in Jesus Christ as the Son of the Living God and as the only way to fellowship with God.
I am aware that I am a witness of Christ daily to those around me, through my speech, behaviors and attitudes.
As an ambassador for Jesus Christ to those who do not know Him, I am committed to draw on His strength, daily, to show love to them through my words and actions.
I am in agreement with and will uphold the Constitution and Statement of Faith of Immanuel Bible Church during the time of my missionary service.

Initial Here

I am willing to serve Christ and others in a cross-cultural setting.
I am willing to accept a change in living conditions/standards.
I am willing to set aside personal preferences in manners of dress and conduct in order to represent Christ and Immanuel Bible church in a way that will be considered “above reproach” in a cross-cultural setting.
Specifically, I am willing to abstain from consuming tobacco products and alcoholic beverages for the duration of the trip.

Initial Here

I am in good physical condition, not requiring ongoing care of a physician for the period of my proposed term of missionary service.
I am willing and able to perform moderate amounts of physical labor (for example: walking to ministry sites, painting, light construction).
I am willing to work as part of a team, avoiding interpersonal conflicts at every opportunity.
I am willing to submit to team leaders.

Initial Here

I take responsibility for the full cost of this trip. I (or my family) am willing to provide any balance not covered by trip fund development.
Upon return from this STOMP, I am willing to present our group experiences and lessons learned to IBC ministries and ABFs.

Initial Here

* Copies of the Immanuel Bible Church's Statement of Faith can be obtained at the IBC information desk or on our website.

By typing in your full name below, you are providing an electronic signature affirming that all the statements and declarations in this application are truthful and trustworthy.

Signature

Date