CCF Beyond Short-Term Mission Trip (STM) Taiwan Prayer Walk Personal Information Name * First Name Last Name Email * Contact no. * (###) ### #### General Information Have you discussed your interest to join Short-Term Missions with your family and Dgroup? * Yes No Travel Insurance Name of Contact Person in-case of emergency * Relationship with contact person * Contact person's email * Contact person's mobile number * Educational Background College / University attended Course and year graduated Post-graduate school attended Course and year graduated Bible Seminary school attended Course and year graduated Skills and Employment Background Present Employer Type of work / profession * Other skill set you think might help in the mission trip (Phography, Media, Teaching, Cooking, Medical, Arts, Music, etc.) Please be specific as possible. * Church & Ministry Background Share your Personal Testimony (Before Christ, Turning Point, After receiving Christ) * Please share your specific experience and involvement in the ministry. If none, you may share your situation or challenges that explain why you're not yet involved in a ministry. * Please inform us of any cross-cultural experiences you've had, if applicable Medical Questionnaire Note: If some health concerns come along the way, you may be asked to submit a clearance from your doctor and may be asked not to join the Mission trip upon the leadership discretion. How do you rate your general health? * Excellent Good Fair Poor Share with us your health concerns including physical and psychological concern. * Have you been sick which required you to visit a doctor or be hospitalized in at least 6 months? Provide details. * Do you have allergies to certain food, medicines, or other things? Provide details. * Are you taking any medication prescribed by your physician? Provide details * Other Personal Details: Please answer as truthfully as you can. Have you ever been convicted of any crime in the past? If yes, please explain briefly. * Do you have any significant or outstanding financial debts and obligations? * Yes No Are there any matters that, if discovered, could be used against you or negatively impact your credibility and should be discussed prior to your being considered as a candidate? Please check the appropriate box. * You do not need to state the specifics on this form. In order to keep these matters confidential simply indicate below that you have something to discuss. Illegal Business Dealings Church Conflict Divorce or Separation Marriage / Family issues Legal Matters Financial Issues Homosexuality Present Relationships Past Indiscretions Nothing that I know of Thank you for your honesty! Agreements With my best of ability, I answered the above questions completely and honestly. CCF Beyond will ensure that we are covered by a Travel Insurance during our Short-Term Missions Overseas Trip. CCF will do all humanly possible steps in protecting you from possible untoward accidents or incidents that may occur during your participation and minister to you when the need arises. However, should there be any unforeseen accidents that might happen during the Missions Trip, I agree to not hold CCF Beyond or its representatives responsible. * Yes, I agree No, I do not agree The information collected and stored will be used solely for the purpose of the CCF Beyond, which is not limited to the application and registration process during related events and activities. Changes will only be made upon the collection of updates by CCF Beyond and/ or the request of the participant. Any and all disposal of data will be carried out securely and within the timeframe provided by CCF. Information stored in a third party database system is subject to the privacy policy of CCF. The participant waives any and all possible liability upon the disclosure of personal data to CCF. * I agree with the above data privacy policy I do not agree with the above data privacy policy Thank you for your interest in joining CCF Beyond’s Short-Term Mission trip! We pray for your journey ahead as you seek God BEYOND the horizon!
