Application for a Short Term Outreach *Denotes Required Field * Title Contact Detail * Name as it appears on passport Name if different from above * Passport Number * Address * Phone ( ) - * Email * Date of Birth Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 * Marital Status Please select an option Married Single Divorced * Application for (country) How did you hear about this opportunity? Please check all that apply. Bulletin Announcement Information Night Previous Team Presentation Friend Webpage Event Other Other Calling and Motivation * Please describe your purpose or calling for joining this Short Term Outreach (STO). What, if any, are your personal goals for being on an STO team. Background and Ministry * Please give a short description of your life story, including your journey to/of faith and any relevant/current life circumstances that we should be aware of that may impact your ability to serve. * Share your ministry training and/or ministry experience. * What are your gifts and strengths in ministry? (If you are not sure, asking a friend that know you well could be helpful.) * Please share how you are currently or recently were involved in service within your local church or community. (Serving in an international context should not be your first exposure to serving God's people) * Are you willing to set up a prayer and fund-raising support team? If no, please explain. (Support raising is an important act of faith in the journey of mission. There are many different ways to raise support which the team will work through together, including training) * Do you have any questions at this time? Contact and Reference from Your Local Church * Church where you hold membership or regularly attend * Name of reference (pastor or leader) who knows you personally * Contact number of reference ( ) - * Contact email of reference * How does your family feel about you going on an Outreach at this time? Do you have their full support or is there any hesitation or concern? Is there anything in your current family or home situation that we should know? Do you have the full support of your spouse (if applicable) to be part of this outreach? If so, please have your spouse sign the form as well as provide their email address. If your spouse has any questions or concerns, please have them contact Mission@CrossRoadsChurch.ca Spouse's Email