Nicaragua Short-Term Mission Trip
Short-Term Trip Destination: Nicaragua
First Name
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Last Name
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Address
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City
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State
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Zip Code
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Home Phone Number
Cell Phone Number
Work Phone Number
Your Email Address
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Current Residency Status
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U.S. Citizen
Other
If "Other" enter residency status
Do you have a current passport? (Passport cannot expire within 6 months of departure)
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No
Yes
Passport Number
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Place issued
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Date issued
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Date of birth (MM/DD/YYYY)
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Gender
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Male
Female
Marital Status:
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Single
Married
Widow/Widower
Member of Eastminster
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No
Yes
Non-Member: What church do you regularly attend and for how long?
Previous Trips
Have you been on a Short-Term Missions Trip before?
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No
Yes
If yes, enter the name of the last sending organization:
Destination of last trip:
Dates of last trip (MM/DD/YYYY to MM/DD/YYYY)
Purpose of trip:
Please give a brief testimony concerning the circumstances that caused you to recognize your need for Christ and acceptance of Him as your Lord and Savior
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Please briefly explain your understanding of the Gospel:
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What are you currently doing to encourage growth in your spiritual life?
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What is your purpose/your goals for this Short-Term missions trip?
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How does this Short-Term missions trip support the Great Commission?
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Please give two personal, non-related references:
Reference 1 Name:
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Reference 1 Address:
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Reference 1 City and State:
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Reference 1 Phone:
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Reference 1 Email:
Reference 2 Name:
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Reference 2 Address:
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Reference 2 City and State:
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Reference 2 Phone:
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Reference 2 Email:
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