Emergency Contact Number*
Do you have any chronic or current health problems that might be affected by the environment and living conditions in a third world country?*
If so, what is the health condition?
In which of these areas do you feel like God has gifted you? (Please check all that apply.)*
The church to which you belong*
Church ministries in which you are/have been involved
Have you ever been on a mission trip?
Statement of Beliefs*