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662-685-4771 ext 137
tmoser@bmc.edu
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PHOENIX SPRING BREAK TRIP
March 9-15 ($1,200)
WESTERN EUROPE TRIP
May 15-26 ($2,600)
Interviews in January
Apps due with $100 deposit January 23rd with $500 due 2/13, 2/27, 3/19, 4/2, 4/16
Sentinel Training will be required!
Trip
Western Europe (May 15-26) Cost $2,600
Phoenix (March 9-15) Cost $1,200
Name
Cell
Address
City, State, Zip
Campus Residence
Date of Birth
Marital Status
Contact in Case of Emergency
Emergency Contact phone
Emergency Contact Address
Emergency City
Emergency Contact State
Emergency Contact Zip
Health Insurance Policy Company
Health Insurancy Policy Number
Church Membership
Will this church help support you financially?
Mailing Address of Church
How often do you attend church while in college?
Weekly
2-3 times a month
Once a month
Occassionally
I am not attending a church.
Where do you attend church while at college?
Do you have a passport? Make sure it will not expire while on the trip.
Church City, State, Zip
How else do you plan to raise funds for this trip?
Have you ever been on a mission trip before? If so, where?
What were your responsibilities?
Have you ever shared with another person your salvation experience?
Are you willing to attend all of the orientation sessions to prepare for this trip?
Do you have any experience in speaking a foreign language? Which one?
What are some of your talents and abilities which you think will be beneficial to this team?
Briefly give your testimony in a short paragraph.
How did God speak to you about being a part of this mission trip?
What do you hope God will do in your life while on this trip?
Do you have any experience driving a van?
Would you be willing to drive a van if we use one?
I have spoken with my family , and they have given me permission to go on this trip. I have read the qualifications and filled out this application to the best of my ability.
Thank you for contacting us.
We will get back to you as soon as possible
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CONTACT
662-685-4771 ext. 137
Director: tmoser@bmc.edu
Assistant: tmiller@bmc.edu
Physical Address:
201 West Main Street
Blue Mountain, MS 38610
Mailing Address:
Blue Mountain College BSU
PO Box 160
Blue Mountain, MS 38610
BMCU
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