Application for Short-Term Mission Service Name * First Name Last Name Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Email * Date of Birth * MM DD YYYY Vocation or Relevant Skills * Emergency Contact * First Name Last Name Relation of Emergency Contact Background Questions Have you accepted Christ as your savior? * Yes No Have you been baptized by immersion? * Yes No Are you a member of FCC? * Yes No If no, how long have you attended? How many mission trips have you taken? * 0 1 2 3 4 5 more than five Please describe any health, physical or dietary issues that may be a factor in your ability to serve * Questions About Your Desired Trip What is the purpose and destination of the short-term mission you desire to participate in (i.e. build a church in Oaxaca, Mexico)? * What are your personal objectives for participating? * What is the scheduled departure date? MM DD YYYY What is the scheduled return date? MM DD YYYY If there is a sponsoring agency, please provide the name, address, phone number and website. Will you participate in a post-trip report to the Global Missions Team or the FCC congregation? Yes No Funding The GMT can help with an individual grant. If a grant will be requested, use these guidelines to help is assessing the amount to request. For costs up to $500, a grant of $75 For costs from $525 to $1,500, a grant of $150 For costs from $2,525 to $3,500, a grant of $400 For costs of #3,525 and greater, a grant of $500 What is the estimated cost for your trip? * $ Percent of trip you will personally finance: * Percent of trip your will fund raise to cover: * Percent of trip you are requesting an FCC grant for: Thank you for submitting your trip application. Someone from the Global Missions Team will reach out to you shortly.
