Project Homework application

 APPLICATION FOR SUMMER MISSION “PROJECT HOMEWORK”

WEAKLEY COUNTY BAPTIST ASSOCIATION

195 Hunt Street, Dresden, Tennessee 38225

(731) 364-9762 FAX NUMBER

 

 

DATE OF MISSION WORK: July 8-13, 2018                            PLACE OF MISSION WORK: Weakley County Tennessee                         

 

NAME:______________________________________________ AGE:______________ BIRTHDATE: _________________SEX: M     F

                                                                                                                              (Must have completed 8^th grade)

SHIRT SIZE (Circle One):         Small         Medium            Large             XLarge             XXLarge            XXXLarge

 

ADDRESS:_________________________________________________________________________

 

CITY: _________________________________________________ STATE: ________ ZIP CODE:___

                               

HOME PHONE: __________________________________ CELL PHONE: _____________________

 

EMAIL: ____________________________________________________________________________

 

CHURCH MEMBERSHIP:_____________________________________________________________

 

EMERGENCY CONTACT: ____________________________________________________________

 

RELATIONSHIP TO VOLUNTEER:_____________________________________________________

 

ADDRESS: ________________________________________________________________________

 

CITY: _________________________________________________ STATE: ________ ZIP CODE:___

 

Have you participated in a previous associational mission trip?       Yes     No

Please check the areas which you are interested in serving:

o Construction    o VBS     o Other_____________________________

 

MEDICAL INSURANCE COMPANY:____________________________________________________

 

POLICY NUMBER:__________________________________________________________________

 

CURRENT MEDICATIONS:___________________________________________________________

 

ALLERGIES:_______________________________________________________________________

 

OTHER SPECIAL NOTES:____________________________________________________________

 

 

SIGNATURE OF VOLUNTEER: _______________________________________ DATE:__________

                            

FOLLOWING TO BE COMPLETED BY VOLUNTEER’S PASTOR OR CHAIRMAN OF DEACONS

We certify that the above named volunteer is a member in good standing of our church and that they are faithful in attendance and support of the church program and pastor.  We recommend them to you as they endeavor to serve the Lord in missions.

 

SIGNED:______________________________________________________      DATE:____________

 

The trip fee for 2018 is $75. To be considered a part of the mission team, this form and the trip fee must be returned to the WCBA office by May 31, 2018.

 

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