2017 Mission Trip Application

Thank you for your interest in serving Christ and His Kingdom all over the world with BCC!

Please fill out the form below to apply for any of our 2017 Mission Trips.

Personal Information
Please fill out the information below to the best of your ability.
Full Name (as appears on passport) *
Full Name (as appears on passport)
Nickname
Nickname
Which Mission Trip(s) are you interested in applying for? *
(You may choose more than one trip)
Cell Phone *
Cell Phone
Home Phone
Home Phone
Address *
Address
Date of Birth *
Date of Birth
Month/Day/Year
Gender *
Home Church *
Do you regularly come to BCC?
(Located on upper right corner of page with photo)
Spouse's Name
Spouse's Name
If married
Spouse's Cell Phone
Spouse's Cell Phone
If married
General Information
If yes, please write down their names.
Please put down a person we could contact in the case of an emergency and their relationship to you.
Emergency Contact's Phone Number *
Emergency Contact's Phone Number
Where do you work and/or what are special skills that we should know about to use you effectively on the trip?
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? How did you come to faith in Jesus Christ? How are you growing in him?
Have you been Baptized? *
The way the Bible and BCC encourages people to be Baptized is after someone has put their faith in Jesus and will choose to follow Him. After your choice to trust in Jesus Christ, then you have been immersed (dunked) under water in the name of the Father, Son, and Holy Spirit. If you want to go on a mission trip and have NOT been baptized, check "No" and the trip leader can follow up with you about your desires to follow Jesus before going on him mission.
Explain why do you want to go on this mission trip?
What are you interested in? What are your hobbies? What activities are you involved with in school?
What would you say your area of spiritual gifting?
Medical Information
his information will only be shared with those within BCC that have a critical need to know for mission planning.)
Medical Information - General *
Mission trips often take place in countries where access to medical care is limited. Mission trips often require long hours of work sometimes in very hot climates where air conditioning is not available. Individuals with any medical problem that is unstable or could be made worse on the mission trip need to discuss their participation with their doctor at least two months before departure. BCC may require a physician's note when there is concern about an individual's ability to safely participate. Have you read and understand this statement?
Please list all Allergies to medications, food or environmental exposures (such as bee/wasp stings).
Physical Capabilities
Physical Capabilities
Please answer the questions below to the best of your ability.
I can lift 40 lbs or more and do heavy physical labor.
I can climb 3 flights of stairs without problems.
I can walk continually for a mile or more.
I can walk at least 100 yards but less than one mile continuously.
This includes but is not limited to high blood pressure, heart disease, asthma, chronic lung disease, diabetes, chronic pain requiring pain medication, immune deficiency, cancer not in remission, limited mobility secondary to back or leg problems, pregnancy: