1. Name:
2. First Name Preference (No nicknames please):
3. Training Camp You Are Signing Up For: Jacksonville, FL: October 15-19, 2008 Rochester, NY: November 5-9, 2008 Seattle, WA #2: November 12-16, 2008 Seattle, WA #3: January 21-25, 2009 Sacramento, CA #2: January 28-February 1, 2009 Los Angeles, CA: February 18-22, 2009
4. Training Camp (Second Choice): Jacksonville, FL: October 15-19, 2008 Rochester, NY: November 5-9, 2008 Seattle, WA #2: November 12-16, 2008 Seattle, WA #3: January 21-25, 2009 Sacramento, CA #2: January 28-February 1, 2009 Los Angeles, CA: February 18-22, 2009
5. Home Address:
6. Home Phone Number:
7. Email Address:
8. Birth Date (dd/mm/yyyy):
9. Grade Completed (by June 30):
10. Can you go on a trip during the school year?

1. Name:
2. Relationship to you:
3. Address:
4. Home Phone:
5. Work Phone:

1. Church Name:
2. Address:
3. Pastor:
4. Phone:

1. Please list the ministries you participate in:
2. Are you involved in leading any church program or ministry? If so, what do you do?

Do you have medical insurance that covers you anywhere in the world? If so, please fill out the insurance information below. If you do not have medical insurance that covers you anywhere in the world, you will need to purchase short-term medical coverage for travelers and provide that information to YMI before going on a trip.

1. Insurance Company:
2. Policy #:
3. Address:
4. Phone:

1. Do you have any health or related problems that might restrict your participation in an international mission trip? If yes, please explain here:
2. If you will be using any medication (including inhalers) please list here:
3. Do you have any allergies whatsoever-to food, medications, or anything else?
   Please list here:

1. Please tell us how you became a Christian - your testimony. Tell us why you have salvation, including scriptural support:

2. Please answer the following questions:

   Why do you want to be a member of a YMI Missions Team?
3. Will you completely submit to your team leaders, ministry site leaders, and YMI staff during Training Camp and the trip? If the answer is no, please explain why here:

By typing in my name below, this constitutes a signature and indicates that I have freely chosen to participate in a Youth Missions International mission trip and have my parent(s) or legal guardian(s) approval. I also agree to submit to the policies and directives of the Youth Missions International organization and appointed leadership while at Training Camp and on any subsequent Youth Missions International trip.

1. Parent/Guardian: Date:
2. Applicant: Date:

*After you submit this form, do not forget to download the Reference Forms, and send in your $50 for the application fee. You will need to do both these things to complete your application.