Long Term Missionary Application

BASIC INFORMATION

Name*

Goes by 'Name'

Address*

City*

State*

Zip*

Email*

Phone*

Birthdate*

Gender*

MaleFemale

Do you currently volunteer for Healing Haiti?*

YesNo

If yes, where?*

YOUR CONTENT GOES HERE

Have you been convicted of a felony?*

NoYes

If yes please explain.

YOUR CONTENT GOES HERE

Emergency Contact*

Relationship*

Phone*

Email*

YOUR CONTENT GOES HERE

Religious Background*

Current Church*

YOUR CONTENT GOES HERE

Please complete a Spiritual Gifts assessment at: https://healinghaiti.org/trips/adult-spiritual-assessment/

Top 5 Spiritual Gifts:

What led you to seek out this opportunity to serve in Haiti?*

Have you volunteered for other organizations? (If you checked yes, please continue below)*

YesNo

Organization Name(s)*

What strengths do you possess that would help you on the mission field, please explain?*

What types of things do you participate in to enrich your relationship with God?*

What areas of weakness will challenge you when you serve in the mission field, please explain?*

How would you describe your health?*

What types of things do you participate in to enrich your relationship with God?*

What strengths do you possess that would help you on the mission field, please explain?*

What areas of weakness will challenge you when you serve in the mission field, please explain?*

How would you describe your health?*

List any physical limitations*

Thank you for completing our application.