Name:

Parent or Gaurdian:

Address:

City:

State/Province:

Zip/Postal Code:

Country:

Home Phone:

Work Phone:

eMail Address:

Occupation:

Age:

Gender:

How did you hear about Mission To Haiti?

If someone told you about Mission To Haiti, who was that person?

Which mission team would you like to serve on? If the team you request is full, we will refer you to the next available mission team.

8 day teams cost $450 / 10 day teams cost $550

If approved, will you be traveling with other team members to Haiti?

If you are traveling with a group, who is your group leader?

Group Leader:

Home Phone:

eMail Address:

What training, skills or special talents do you have? Please tell us what your primary skills are and if you have any other abilities.

What hobbies or personal interests do you have?

From the work teams we have, where do you feel you would like to serve?

Your work team assignment will be made based on your skills, the work teams available and where you are needed most.

Do you speak a foreign language, and if so which one(s)?

Do you have any medical conditions that we should be made aware of?

No

Yes. If yes, please explain

In case of an emergency while in Haiti, who should we contact?

Relationship

Home Phone

Work Phone

Which church do you attend?

Yes, I'm a member

No, I'm not a member

What do you do in your church? e.g. teach Sunday School, sing in the choir, deacon ...

If needed, who can we contact as a reference for you?

Relationship

Home Phone

Work Phone

Comments

Please provided us with any comments that will help us process your application.

Here are some important things to know about serving on a mission team

• You must have a valid passport to enter Haiti. Your visa will be issued on the plane.

• Bring modest clothes. You must dress modestly while in Haiti in keeping with the Haitian culture. Clothes that are acceptable back home may not necessarily be good for the camp or work site.

• Treat others with dignity and respect. Inappropriate behavior will not be tolerated.

• Watch your language. Four letter words are not appropriate on the mission team.

• Buy your plane tickets to arrive and leave Haiti on the team dates. Do not arrive before the team or leave after the the team is in Haiti.

• Follow your team leader. Stick with the work team you have been assigned to. Follow the schedule of your work team.

• Have a servant's heart. The best ability is availability. Be willing to serve wherever you are placed. Your cooperation will bring harmony to the team and glory to God.

• Read the team booklet. It has valuable information on what you will need to bring and what to expect while in Haiti. You will find a copy to download on the mission team page of this site.

Thank you for filling out this application asking to join a mission team. Upon being approved, you will be sent additional information to review and a payment schedule for the mission team you have requested to attend.