HHYC Compass Ministries

HHYC Compass Ministries

Application for 2019 Mission Trips
This form should be completed and submitted by each applicant. Trips have a limited number of spots available. Applications turned in first will have priority.
What trip are you interested in?
If your first choice is not available, what is your second choice?
Personal Data
Full Name (as on passport, if applicable)
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Home Phone

Area CodePhone Number
Cell Phone

Area CodePhone Number
Birth Date

MonthDayYear
Gender
Do you already possess a current passport?

YesNo
Driver's License #/Passport/Student ID # (indicate which is given
T-shirt Size
Name(s) of parent or guardian (if you are under 18)
Phone Number

Area CodePhone Number
E-mail
Church of God (Holiness) "COGH" Involvement
Do you attend COGH worship services?

YesNo
If yes, how long?
Are you a member of COGH?

YesNo
If yes, how long?
Have you served in a ministry at COGH?

YesNo
If yes, which ministries?
Are you a part of a small group or Sunday school class?

YesNo
If so, which one?
If you are a member of a church other than COGH, please give the name, address, phone number, and pastor's name.
Mission Experience
Have you traveled on previous mission trips?

YesNo
If yes, please give the locations and dates.
Skills and Talents
Please mark which skills/talents you possess.
Please describe your skill level for each marked above: 0-I stink; 1-Average; 2-Above average; 3-Professional
Ministry Experience
Teaching (class/age)
Children's ministries
Other
Performance Skills
Instrument (please list)
Vocal
Other (please specify)
Please list other performance skills you have (e.g. juggling, puppetry, drama, walking on hot coals, etc.)
Personal Spiritual Formation
Describe your personal relationship with Jesus Christ.
Why do you feel God is calling you to serve in this way?
Emergency Contact Information
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Home Phone

Area CodePhone Number
Cell/Work Phone

Area CodePhone Number
Relationship to Applicant:
Medical Information

Please be honest and complete with your medical history since this information is important to the environment in which you may be working.
List all medical problems for which you have received medical care in the past 12 months.
List any prescription drugs (and their generic names) which you are now taking.
List any history of major illness or surgery.
List any known allergies (including food allergies) or chronic, life-threatening conditions.
List any known physical limitations and/or disabilities.
Insurance Information

A copy of your insurance card must be presented before you go on the trip.
Name of your insurance company
Insurance ID #
Signature
Applicant's signature
Signature of parent/guardian (if applicant is under age 18)
In order to reserve your spot for this trip, you must turn in your application with $100. The $100 will go toward the cost of your trip. Since the money is necessary to reserve your spot, it is non-refundable except in the event that your trip is full or your application is rejected.

Your application fee may be made payable to "World Missions" with a note in the memo line and mailed to PO Box 4711, Overland Park, KS 66204. Or, you can click here to give online (select "HHYC Compass Ministries--Application Fee").
Should be Empty:

HHYC Compass Ministries

Personal Data

Church of God (Holiness) "COGH" Involvement

Mission Experience

Skills and Talents

Ministry Experience

Performance Skills

Personal Spiritual Formation

Emergency Contact Information

Medical Information

Insurance Information

Signature