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Mission Service Team Application

Your email address: Church name:
Church address: Name of Team:
Church Phone: Contact Person:
Contact Person's Phone #: Contact Person's E-mail Address:
Address (If different than church address):
Dates Desired: First Choice Dates Desired: Second Choice
Number of Team Members: Number of Adult Team Members: Number of Youth Team Members:
Number of Male Members: Number of Female Members:
Will Your Team be Using a Group Insurance Policy: Yes No
If So, What is Your Insurance Company and Policy Number:
Types of Projects Your Team Feels Comfortable Doing:

Specialties of Skilled Team Members:

Anticipated Mode of Transportation: Number of Vehicles:
Date Submitted:
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