Thank you for applying for the Kenya Mission Trip. Once you submit your application and supporting documents you will receive notification within 7 days about whether or not you have been selected for the trip. To complete this application you will need your driver's license and passport, names and contact information for 3 references, and your testimony of how and when you accepted Christ.

You can pause and return to this application at a later time using the same device until you click submit.

Approximate travel dates March 30th – April 7th 
Deadline for applications is February 20, 2019. Space is limited. 

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* 1. First name (Please use your LEGAL name)

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* 2. Middle name (if none leave blank)

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* 3. Last name (Please use your LEGAL name)

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* 4. Date of birth

Date

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* 5. Gender

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* 6. Primary Email for Correspondence

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* 7. Alternate Email

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* 8. Cell Phone Number xxx-xxx-xxxx

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* 9. Home Phone Number   xxx-xxx-xxxx

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* 10. Street Address

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* 11. City/Town

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* 12. State

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* 13. Zip Code

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* 14. If you are selected for this mission trip what airport(s) would you like us to look at for flights?

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* 15. Social Security Number

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* 16. Driver's License Number

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* 17. Driver's license state

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* 18. Driver's license expiration

Date

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* 19. Are you a U.S. Citizen

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* 20. Please check all boxes that apply. A “yes” statement does not necessarily disqualify you from being selected. Additional documentation may be needed.

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* 21. Please provide further information on any items checked above.

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* 22. Occupation (nurse, homemaker, engineer, student, etc.)

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* 23. Name of employer if employed outside the home. 

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* 24. Number of years with employer (round to whole numbers).

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* 25. If a student, please list the name of your school.

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* 26. If a student, please list your grade in school

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* 27. Name as it appears on passport.

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* 28. Passport Number.

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* 29. Passport Expiration Date.

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* 30. Place of Issue (Country, State, & City)

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* 31. Date of Issue

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