Global Reach Mission Trip Application

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*WE ARE ONLY TAKING THE CAMBODIA TRIP IN 2019*
The age requirement for short term trips with Global Reach for Justice is 18 years of age. There are times where minors may be allowed
to join us after a personal interview process and submission of references. We encourage minors to be accompanied by a parent or
legal guardian. If you are a minor, please provide us with a parent/guardian’s name, phone, and email:

Email *

Name: *

Mailing Address - City, State, Zip Code *

Age: *

Home Phone Number:

Cell Phone Number: *

Parent/Guardian Info: Name (First and Last), Phone and, E-mail. *

Have you ever been short or long-term Mission Trip? *

Yes

Where did you go?

Duration of the Trip?

When did you go?

YYYY

Purpose of the trip?

Do you have a current passport? (If you answered "no" we encourage you to get one as soon as possible as it may take time to receive it. *

Yes

Do you have any medical issues major or minor? (Please Explain) *

Any known allergies? (If so, please list them) *

Do you regularly attend a local church?

Yes

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Name of your pastor?

Are you in good standing with your church or pastor?

Do you serve in your church? (If so please explain)

Share with us in a paragraph why you feel you should go on a Global Reach Mission Trip? *

Please Submit 3 Personal Non-Relative References

(LIST THERE NAME, PHONE, ADDRESS, E-MAIL, AND HOW MANY YEARS YOU'VE KNOWN THEM)

PASTOR REFERENCE *

REFERENCE 2 *

REFERENCE 3 *

A copy of your responses will be emailed to the address you provided.

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