Youth Missions International

Applicant Information

Name (as it appears on your birth certificate):
First Name Preference (No nicknames please):
3-Week Experience
8-Week Experience
Trip You Are Signing Up For:
Home Address (Street, City, State, Zip):
Home Phone Number:
School Address (Street, City, State, Zip):
School Phone Number:
Email Address:
Birth Date (dd/mm/yyyy):
Is your school on a quarter or semester schedule?
T-Shirt Size:

Emergency Contact Information (not a parent/guardian)

Name:
Relationship to you:
Address:
Home Phone:
Work Phone:

Church Information

Church Name:
Address:
Pastor:
Phone:

Ministry Experience

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

Insurance

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.

Insurance Company:
Policy #:
Address:
Phone:

Medical Information

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

Tell Us Your Story

Please tell us how you became a Christian - your testimony. Tell us why you have salvation, including scriptural support:
Please answer the following questions:
Why do you want to be a member of a YMI Missions Team?
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. 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.

Applicant: Date:

*After you submit this form, send in your $25 deposit. You will need to do this to complete your application.