Brooklyn, NY July 2023
July 6-11, 2023 - Brooklyn, NY Mission Trip Please allow at least 5 minutes to complete form. You will be required to make a deposit for this mission trip at the end of this form.
* Name of Trip/Date
* First Name
* Last Name
* FULL NAME as listed on Driver's License
* Birth Date
* Marital Status
* Mobile Phone
* Spouse's Name
* Spouse Phone
* What Life Group do you attend?
* EMERGENCY CONTACT (List name and #. List allergies or medical condition we should be aware of)
* Are you currently under the care of a physician
* If yes, please explain
* Health Insurance Provider (Please provide your ID#, Group#, Name of Policy Holder, Employer, and Name of Beneficiary.)
* Reference (List 1 person not related to you that you have known for at least 1 year. Provide the person's name, phone #, relationship, & years acquainted)
* Having understood the description of work on this project, please describe the work that you hope to participate in with this team.
* Please indicate any special skills, talents or Christian service experience that you feel may be helpful to this ministry:
* Are you a member of Central Baptist Church?
* If not a member of Central. Please name the church you attend.
* Please list the ministries with which you have been involved outside of your church. (Please include time of involvement and any leadership positions held.)
* Are you willing to be involved in the outreach programs of CBC before and after this mission project?
* Please write, in your own words, how a person can become saved:
* Please write your own salvation story including when you were baptized:
* How are you growing in your relationship with Christ? (emphasizing your prayer life and Bible study/quiet time):
* Give a brief explanation of how you know it is God's will for you to go on this mission project?
* Excluding minor traffic violations, have you ever been convicted of any violations of any law or ordinance?
* Do you have a daily prayer and Bible study time?
* Are you living a lifestyle of pre-marital, extra-marital or homosexual relationships?
* Do you completely abstain from the use of alcohol, illegal drugs, or tobacco products?
* If no, please explain.
* Do you have any physical impairments that prevent you from doing physical work on the mission field?
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