Program(s) of interest: (*)
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Your Name: (*)
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Your Mailing Address: (*)
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Phone: (*)
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E-mail Address: (*)
Please enter a valid e-mail address.
Citizenship: (*)
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Date of Birth (DD/MM/YYYY): (*)
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Home Congregation:
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Congregation Mailing Address, Phone Number, E-mail and/or Website:
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What is your ministry involvement?
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College or University:
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Year or Year Graduated:
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Major or Degree:
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Profession or Occupation:
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Where employed and how long?
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Are either of your parents Jewish?
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Were you raised in a Jewish (or Messianic Jewish) home?
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Are you: (*)
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Shirt Size: (*)
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Emergency Contact Information
Name: (*)
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Relationship: (*)
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Phone: (*)
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E-mail:
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Getting to know you
How did you hear about the program? (*)
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Why do you want to participate in this program? (*)
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Have you been on a short term missions trip? (Where, when, what?) How did it impact your life? (*)
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Have you raised funds for a missions trip before? Do you plan on doing so for this trip? (*)
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Do you have any physical or emotional challenges that would limit your participation on this program? (*)
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Do you have a criminal record? If yes, please explain the circumstances. (*)
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How and when did you come to follow Jesus as your Messiah? (*)
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Have you ever shared your faith in Messiah with a Jewish person? How did it go?
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If you could create your ideal ministry, what would it look like? (*)
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What are your spiritual gifts? (i.e. administration, encouragement, evangelism, helps, leadership, mercy, teaching..."not sure") and identify any special talents, abilities, and passions you have. (*)
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