Application Form

1st Trip Choice

2nd Trip Choice

Before completing this application, answer the following questions: Are you…
…a committed Christian submitted to the Lordship of Jesus Christ?

…old enough to participate in the trip you are applying for (see specific trip requirements)?

…a person with a servant heart, interested in missions work and open to God’s calling in your life?

…ready spiritually, emotionally, and physically (must be able to participate in vigorous activity)?

Personal Information

Photo

Boarding Pass Code

Name

Preferred Name

E-mail

Address

Home Phone

Cell Phone

Do you give CIY staff permission to send text messages (we will NOT send spam texts)?

Gender

Male
Female

Date of Birth

Age

Height

Weight

Marital Status

Citizenship

Parent/Guardian/Spouse

Is your address the same as your parent/guardian/spouse?

Guardian Home Phone

Guardian Work Phone

Church Name

Church Phone

Church Address

Youth Minister

Youth Minister's Phone

If other website/magazine then please specify?

T-Shirt Size

Missions/Service Experience

Know Sweat Experience (Years)

Past Mission Trips (Years)

Other Non-CIY Mission Trips

Education History

Year of High School Graduation

Name of College	Major	Graduation Year

Skills, Talents, Foreign Languages, And Ministry Experience

Please list any skills, interests, hobbies, or talents: (Teaching Bible school lessons; crafts; puppets; building, agricultural, or mechanical skills; medical training; sewing; sports; etc.) Describe your ability and experience for each item you list.

Personality Profile

Describe your personal strengths:

Describe your personal weaknesses:

Relationship with Jesus Christ

Have you been baptized?

When did you become a Christian?

Describe your present relationship with Jesus Christ: