country of ministry trip applying for:storage.cloversites.com... · country of ministry trip...

Country of ministry trip applying for: ___________________________

INSTRUCTIONS: Print this application, fill it out, scan and email it along with a scan or photo of your passport (open to photo page) to: Varian Dean at [email protected]. If you don’t have this ability, fill it out and mail to Varian at the address listed below. Once you sign up we can send you an invoice for the payment of the deposit for $253.00 which covers the processing fee. Please mail the $253 non-refundable deposit to the “Destiny Ministries International” office if you want to pay by check. You are not officially on the trip until a deposit is made. The trips do fill up and usually are limited due to vehicles and housing arrangements. All documents will be secure and kept confidential.

DMI MINISTRY TRIP CONTACT:Email: [email protected](Please scan and send the application and you will receive an invoice for the deposit)

MAILING CHECKS:Destiny Ministries International c/o Varian DeanPO Box 75566Colorado Springs, CO 80970

PERSONAL INFORMATION:Name __________________________________Date of Birth ____/_____/_____

Nickname (Or name you go by) _______________________________ AGE _____________

Gender !Male !Female Occupation ______________________________

Marital Status ! Married ! Single

Street Address_________________________________________________________________

City __________________________________State___________Zip________________

Country_________________ Home (_____)_______________________

Work_____)__________________________Fax (_____)_________________________

Mobile (_____)________________________ Email_____________________________

DESTINY MINISTRIES INTERNATIONAL - PO Box 75566 - COLORADO SPRINGS, CO 80970 PHONE: (719) 924-5399 www.destinymi.com

(EXACTLY AS IT APPEARS ON YOUR PASSPORT) MM/DD/YY

Attach photo

MINISTRY TRIP APPLICATION

mailto:[email protected]




http://www.destinymi.com


MINISTRY TRIP INFORMATION:I am applying for the trip to: _______________________________________________

On the dates of: _______________________

Passport Number____________________________ Expiration Date ____/_____/_____

Country of Issue _________________________

Preferred Airport of Departure City _______________ Alternate Airport_____________

REFERENCE INFORMATION:Pastor or Ministry Leader’s Name_________________________ Phone ______________

Other Reference __________________________________Phone___________________

EMERGENCY CONTACT INFORMATION:Emergency Contact Name_________________________ Relationship _______________ Email Address __________________ Phone Number (______)_____________________

MINISTRY TRIP BACKGROUND INFORMATION:

Have you previously travelled with DMI on a Mission Trip?

!Yes !No If yes, please give the Location and the dates.

___________________________________________________________________

Are you willing to minister according to DMI’S values and guidelines? !Yes !No

How would you describe your personality and temperament? ________________________

Are you fluent in any other language other than English? ! Yes ! No

If yes, what language? ___________________Would you be willing to be a translator

if applicable? ! Yes ! No

What do you desire to see God do for you and through you on this mission trip?

________________________________________________________________________

________________________________________________________________________


DESTINATION (CITY, COUNTRY)

MM/DD/YY




MINISTRY BACKGROUND INFORMATION:

Do you attend church regularly? !Yes !No

Have you been baptized? !Yes !No

What areas of ministry are you currently serving or have served in the past? ________________________________________________________________________________________________________________________________________________________________________________________________________________________

What do you believe are your spiritual gifts? _____________________________________

Have you received any other ministry training? !Yes !No

If so, please explain: ________________________________________________________________________________________________________________________________________________________________________________________________________________________

Have you ever been released from a ministry position? !Yes !No

If so, please explain: ________________________________________________________________________________________________________________________________________________________________________________________________________________________

CHURCH AND MINISTRY INFORMATION:

Name of Church or Ministry_________________________________________________________________

Denomination or Apostolic Affiliation if any_____________________________________

Address________________________________________________________________

City_____________________________________ State________ Zip______________

Phone ___________________________ Fax____________________

Email________________________





MEDICAL AND INSURANCE INFORMATION:Do you have any physical disability? !Yes !No If so, please describe: ________________________________________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________________________________

Have you ever been treated for any mental or emotional condition? !Yes !No If so, please describe: ________________________________________________________________________________________________________________________________________________

Please list any condition that may prevent your participation:_____________________________________________________________________________________________________________________________________________________________________________________________________________

Are you currently taking any medications?________________________________________________________________________

Please list any allergies to food, medicine, etc. ________________________________________________________________________________________________________________________________________________

Do you have primary medical insurance? !Yes !No If so, what is the name of your insurance carrier? ________________________________________________________________________

I, ____________________, hereby confirm that I’ve prayed and sought counsel about going on this missions outreach. By signing this waiver, I promise to uphold godly values while on this trip and to submit to leadership and those responsible for my safety. I also acknowledge that I am in good physical and emotional health, and will not hold Destiny Ministries International, or their employees or agents liable for any harm, sickness or injury to me that may result from this trip. I will check with my doctor and make sure that all my vaccinations are up to date. I will obtain a valid passport and necessary visas when necessary. I also understand that the price may change due to airfare increases and departure city. I know that the application is not complete until this waiver is signed and a deposit is received.

Signed _______________________________________ Date _____/_______/_______





country of ministry trip applying for:storage.cloversites.com... · country of ministry trip...

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