2016 Haiti Mission Trip Application

Thank you for filling out the application to go on the trip to Grand Guave, Haiti! 

  • Trip dates: July 12-21, 2016
  • This trip is for those who are currently in 15 and older
  • A $300 deposit is due January 1, 2016 
Full Name
Full Name
Cell Phone *
Cell Phone
Home Phone
Home Phone
Address *
Address
Date of Birth *
Date of Birth
Month/Day/Year
Gender *
(Only needed if under 18 years old.)
Parent's Phone Number
Parent's Phone Number
(Only needed if under 18 years old.)
(Only needed if under 18 years old.)
Home Church *
Do you regularly come to BCC?
What are you interested in? What are your hobbies? What activities are you involved with in school?
Past Mission Trips *
Have you been on a mission trip before?
If you have been on a mission trip, tell me about it. Where and when did you go? What did you do? What ministry was it with? Anything else you want to tell about the trip.
If you were to tell someone about your faith, what would you say?
Why do you want to go on a mission trip?