The information required in this form is confidential and will be treated as such. Please be completely honest. Read every question carefully and make sure you answer them to the best of your ability.

SECTION A: GENERAL INFORMATION

Full Name as in Passport*

Date of Birth*

MM

DD

YYYY

Gender*

Marital Status*

PASSPORT INFORMATION

Passport Number

Date of Issue

MM

DD

YYYY

Date of Expiration

MM

DD

YYYY

Country of Issuance

Place of Birth

Number of Empty Pages

CONTACT INFORMATION-As listed on Driver's License

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email*

Home Number*

Cell Number*

Work Number

Best Number and Time to Contact*

Emergency Contact 1

Name*

Relationship to contact*

Email*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Home Phone*

Cell Phone*

Work Phone

Best Way to Contact*

Emergency Contact 2

Name*

Relationship to contact*

Email*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Home Phone*

Cell Phone*

Work Phone

Best Way to Contact*

ACADEMIC INFORMATION

Level of Academic Completion/Which Schools:*

Occupation or Area of Study:*

Certifications/Foreign Languages:*

SECTION B: PERSONAL INFORMATION

What are your gifts and talents in the area of sports, music, arts, hobbies, etc:*

Summarize any experience or training you have had related to Christian ministry:*

What kind of travelling/mission work have you done before? Where? When? And for how long:*

Name two of your biggest fears:*

What makes you feel good about yourself:*

When do you want to withdraw from people:*

What are things you would like to change about yourself:*

Employment Information:

Current Employer:*

Address:*

Job Title:*

Previous Employer:*

Previous Job Title:*

SECTION C: FAMILY

Please list parent’s names, jobs, and employers:*

Are your parents still married? Describe your relationship with them:*

Please list your siblings and their ages:*

Describe the relationship you have with your siblings:*

SECTION D: RELATIONSHIPS

Describe your conduct towards those in authority:*

What type of leader frustrates you the most:*

What advice would you give to potential leaders:*

Who has the greatest influence in your life (besides Jesus) and why? Please explain:*

SECTION E: SPIRITUAL GROWTH

Please describe...

1. How you came to faith in Jesus Christ:*

2. How your walk has grown since then until now:*

3. What you are involved in now to strengthen your walk with Jesus:*

4. How God called you to Global Journey and why you have applied:*

SECTION F: FINAL QUESTIONS

What church are you currently involved in:*

How do you deal with sudden changes in plans:*

What are your expectations for your around the world adventure:*

If you are accepted to Global Journey, how do you intend to raise the needed funds:*

Should you be accepted to Global Journey, what could stand in your way of taking part this summer:*

SECTION G: REFERENCES

Please Include 3 References of the following categories: 1. Employer 2. Christian Worker 3.Your Choice

Reference 1 - Name / Position*

Reference 1 Phone*

Reference 2 - Name / Position*

Reference 2 Phone*

Reference 3 - Name / Position*

Reference 3 Phone*

Thank you for filling out this application!

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