Missions Trip Application

Capital Missions Trip Application

We are thrilled that you are applying to go on a Missions trip with Capital Christian Center in 2022-2023.

After submitting this form, you will receive an email confirming that we have received your application. On a later date, you will be contacted from a team leader to set up an interview for further processing.

AGE REQUIREMENTS (Burkina Faso, Saudi Arabia or Israel)

+Minimum age 18 if traveling without parents (must be a high school graduate; individual cannot be supervised by other adults)

+Minimum age 14 if traveling with a parent (child must share room with parent)

**ADVISORY**

Capital Christian Center’s Missions trips are not suitable for all individuals. Before signing up for a Missions trip, we ask that you prayerfully consider your overall health and personal physical condition as weather can be extreme and conditions can be harsh.

Name (Exactly as on your Passport)

Name you go by (if different from above)

Gender

Male
Female

Date of Birth

Address

Cell Phone Number

Alternate Phone Number (Home/Work/Etc)

Confirm Email

Will anyone else be traveling with you?

Which mission week are you applying for?

Burkina Faso 2022- Robert Peterson Lead - Construction, Medical
Saudi Arabia 2023- Pastor Armen Divanyan Lead- Children's Outreach & Education
Israel 2023 - Pastor Rick Cole - Construction/Medical/Humanitarian

Emergency Contact Info

Emergency Contact

Emergency Contact Relationship to Applicant

Emergency Contact Email

Confirm Emergency Contact Email

Emergency Contact Phone Number

If you are a student or under the age of 21, Your Parent(s)' or Guardian(s)' Name(s) & Address

Tell Us About Yourself

Occupation and/or School

Professional Title (MD, RN, PA, NP, etc)

Medical Specialties (if any)?

Current Church Membership

Skills

Tell us about yourself. Why do you want to go?

First Language

List additional spoken languages

Please tell us about your previous mission trip experiences.

Do you have any medical conditions or allergies?

Passport Information

Country of Citizenship

Passport Number. (This is required. If it is not available at this time, please complete this form and email a color copy of your passport to [email protected])

City & State of Birth

Passport Issue Date

Passport Expiration Date

Final Details

How did you hear about Capital Missions Trips 2022-2023?

Any thoughts, comments or questions?

Today's Date

*NOTE: CCC Missions trips are very strenuous. The weather conditions can be harsh. If you have food allergies or special dietary requirements, know there are no accommodations for such. If this info has given you pause, please stop and prayerfully consider if this mission is a wise choice for you.

Event Registration Software by RegFox