Application for Short-Term Mission Trip

Bethany Evangelical Presbyterian Church
5 N. Concord Ave. Havertown, PA 19083 (610)-789-2486

To be considered for a short-term mission project through Bethany, you must complete and submit this application to Meg DeHaven by October 26th, 2018. This application process may also involve a personal interview. All applicants will receive personal confirmation of outcome of application process by October 27th, 2018.

If you are human, leave this field blank.

PERSONAL INFORMATION

Radio Buttons *

Male

Female

Full Name *

Date of Birth *

Present Address *

Present Address

City

State/Province

Zip/Postal

Country

Home Phone

Cell Phone *

Email Address *

I have a different permanent address

Permanent Address

City

State/Province

Zip/Postal

Country

Is your family supportive of you applying for this trip? *

Yes

Please explain *

EMERGENCY INFORMATION

In case of an emergency while on the mission project, please notify:

Name *

Relationship *

Address

City

State/Province

Zip/Postal

Country

Home Phone

Work Phone

Cell Phone *

Email Address

Health

How would you describe your present health? *

Excellent

Good

Average

Poor

Please list any medications you are currently taking.

Please list any allergies you have.

Primary Physician Name *

Primary Physician Number *

Are you presently under the care of a physician? *

Yes

If yes, please explain. *

SERVICE & CHURCH INVOLVEMENT

Please indicate any skills, talents or service experience that you feel may be helpful on the field.

Are you a member of Bethany Evangelical Presbyterian Church? *

Yes

If yes, how long? *

If no, with which church are you a member or where do you regularly attend, and for how long? *

Are you currently part of a Small Group Bible Study or Sunday School class? *

Yes

Please list previous missions experience:

Country

Church/Mission Organization

Date of Project

Ministry

Add Remove

Please list the ministries with which you have been involved. (Please list the time of involvement, any leadership positions held, and the organization /church which was responsible for the ministry).

Please share any skills and/or interests that might pertain to our trip:

Testimony

Please share you testimony (your story of knowing Christ), use additional paper if needed. Please include how long you have been a believer. *

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Application for Short-Term Mission Service Experience

PERSONAL INFORMATION

EMERGENCY INFORMATION

Health

SERVICE & CHURCH INVOLVEMENT

Please list previous missions experience:

Testimony