Application for Missions

Application to Plan Mission Trip

Please fill out the application form carefully
Personal Information
(Main) Leader's Name

First NameLast Name
(Additional) Leader's Name

First NameLast Name
Application Submission Date

MonthDayYear
Main Leader E-mail
Additional Leader E-mail
example@example.com
Main Leader Phone Number

Area CodePhone Number
Additional Phone Number

Area CodePhone Number
Missionary Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Ministry Trip Information
Purpose of the trip and type of ministry
How many people will go on this trip?
Are the majority of people going minors or adults?

Minors (under 18)Adults
If minors, what ages
If taking minors, what is the ratio of adult leaders to minors?
Will this trip be made available to people from other A/G churches?

YesNo
Will this trip be made available to people from other denominations?

YesNo
If yes to the two previous questions, please explain
Pastor's Name (If overseeing)

First NameLast Name
Pastor's Email
example@example.com
Pastor's Phone

Area CodePhone Number
Request for Team Leader Funds
Enter in whole dollar amounts
Request for Ministry Funds
Enter in whole dollar amounts
Please explain the use of ministry funds
Thank you for your interest in missions; we will contact you with a decision.
Should be Empty:

Application to Plan Mission Trip