Phone number *
Phone type Mobile Home Work Other
Gender *
Select… Male Female
Marital status *
Select… Single Married Widowed Divorced
Do you have any medical conditions or allergies that we need to be aware of? If yes, please list along with any reactions. If not, mark N/A. *
Do you have any physical, emotional, or mental health limitations that you may experience during this outreach? *
If no, put "No."
Have you received treatment for any physical, emotional, or mental health conditions over the last 5 years? If yes, please explain. *
If no, put "No."
Do you have health insurance? *
Are you a born again Christian? *
A born-again Christian is someone who has experienced a spiritual rebirth, or regeneration of the human spirit, through the work of God's Holy Spirit. This process involves repenting of sins, turning to Christ for salvation, and becoming part of God's family.
Select… Yes No Not Sure
Have you ever been on a mission outreach before? *
What is your current occupation? *
Passport Number: *
Put "Not applicable" if you do not have a current passport. Please apply for a passport as soon as possible as we cannot book your flights until that is completed.
Please upload a copy of your passport
Choose 1 file. Maximum file size 10 MB.
List 3 of your personal strengths *
List 3 of your personal weaknesses *
Which trip are you most interested in? *
List any family members that will also be applying for this trip.
Each individual must submit an application.
Why do you want to participate in our Global Reach Trip(s)? *
What do you hope to gain from this experience? *
PERSONAL REFERENCE #1: Full Name *
Please note: This cannot be a family member.
PERSONAL REFERENCE #2: Full Name *
Please note: This cannot be a family member.
Commitment to Unity and Encouragement *
"Let us therefore make every effort to do what leads to peace and to mutual edification." (Romans 14:19, NIV) -Team members must work together efficiently. Avoid unnecessary disagreements. As a team, let’s prioritize unity and encourage one another. Our collective efforts will lead to peace and mutual edification.
Commitment to Respect and Kindness *
“Be kind and compassionate to one another, forgiving each other, just as in Christ God forgave you.” (Ephesians 4:32, NIV) -Treat others with respect. Rudeness will not be tolerated. Let’s practice kindness and compassion towards one another, remembering how God forgave us through Christ. Respectful interactions are essential.
Commitment to Effective and Clear Communication, Spoken in Truth and Love *
"Let your conversation be always full of grace, seasoned with salt, so that you may know how to answer everyone." (Colossians 4:6, NIV) -Speak up when needed but remember our words should be gracious and seasoned with wisdom. Let’s communicate effectively, seeking understanding rather than correction.
Commitment to Respect Cultural Norms in speech, attire and attitude *
"In humility, value others above yourselves." (Philippians 2:3, NIV) -Dress appropriately. Let’s honor the cultural norms in our words and actions for the places we visit. Dressing appropriately shows respect for local customs and values.
I commit to abstain from alcohol, drugs, vaping or smoking while on this trip(s). *
You will be sent information regarding the Live Scan via email. Please get this completed as soon as possible.
We will notify you via email within one week of the application deadline. Please note, the deposit is non-refundable should you no longer be able to attend the trip. Deposit deadlines for Indonesia will be communicated via email.
I authorize The Rock Church and its agents to contact references provided, as well as any sources not provided in order to obtain information regarding my character and fitness for this outreach. I am aware that, should my application be accepted, I will be required to sign a liability release form for this trip. I agree to submit to the policies and procedures of The Rock Church Global Reach Service Trips, and to refrain from unscriptural conduct in the performance of my services on behalf of The Rock Church. I am aware that the Non-Refundable deposit and all deposited money is a financial contribution to this outreach even if I am not able to attend the trip.*
Submit