Long Term Missionary Application Please enable JavaScript in your browser to correctly submit this formBASIC INFORMATIONName*Goes by 'Name'Address*City*State*Zip*Email*Phone*Birthdate*Gender*MaleFemaleDo you currently volunteer for Healing Haiti?*YesNoIf yes, where?*YOUR CONTENT GOES HEREHave you been convicted of a felony?*NoYesIf yes please explain.YOUR CONTENT GOES HEREEmergency Contact*Relationship*Phone*Email*YOUR CONTENT GOES HEREReligious Background*Current Church*YOUR CONTENT GOES HEREPlease complete a Spiritual Gifts assessment at: https://healinghaiti.org/trips/adult-spiritual-assessment/Top 5 Spiritual Gifts:1*2*3*4*5*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)*YesNoOrganization 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. Submit