Mission Application « Vista Community Church

We have been having problems with this application. If you do not get to the page "Thanks You" Then your application did not go through, you may be able to use the back button to access your application again. If this is the case email kim.webb@vistacommunitychurch.org and I will email you some basic questions.

We apologize for the problem and appreciate your patience.
Thank you for your interest in missions here at Vista!
As you fill out this form note that (*) denotes a required field.

Please NUMBER the trips in the order of your preference.
Final determination will be made by Pastor Mike Smith and the Missions Leadership Team based on the balance of the teams, qualifications of the participants, and the focus of the trip.

If there is a week you are unable to attend, please mark an X in the box.

Applications are due on February 19, 2012
Cambodia – Possible trip Mid-Late June
Focus and Team Qualifications still being determined.
Cambodia – Thurs, July 19th - Sun, July 29th
Focus: Training and care for the teachers and staff at Rahab’s House School outside Phnom Penh, Cambodia
Team Member Qualifications: Certified teachers or have qualifications in social work, counseling, or pastoral care.
Africa – Sat, August 18th – Tues, August 28th
Focus: Evangelism Week (including Children's Evangelism Club). Plus, multiple projects in Kenya.
Team Member Qualifications: Eight to ten team members who are spiritual and emotional maturity. An ideal team would consist of the following:
Age minimum 17, 4 Men, 4 Women, 1 Medical Participant, New Missions Participants.

Personal Info
Full Legal Name (First, Middle and Last)*
Preferred Name (First and Last)*
Address*
Street AddressAddress Line 2CityState / Province / RegionZip / Postal CodeCountry
Cell Phone
(###)###-####
Home Phone
(###)###-####
Email*
Date of Birth*

All minors must be accompanied by a parent or legal guardian, unless otherwise approved by Pastor Mike Smith.

Passport Information
Passport
- I currently do not have a passport. I understand that upon acceptance, I will need to begin the passport application process.
- I do have a current passport.
Country of Citizenship
Passport Number
Name on Passport (First, Middle and Last)
City/Country of Issue
Expiration Date
MM
DD
YYYY
Must be valid for at least 6 months from departure date

Emergency Information
In Case of Emergency: Contact Person #1*
FirstLast
Relationship*
Address
Street AddressAddress Line 2CityState / Province / RegionZip / Postal CodeCountry
Primary Phone*
(###)###-####
Secondary Phone
(###)###-####
In Case of Emergency: Contact Person #2*
FirstLast
Relationship*
Address
Street AddressAddress Line 2CityState / Province / RegionZip / Postal CodeCountry
Primary Phone*
(###)###-####
Secondary Phone
(###)###-####

Spiritual Background
Write a brief statement on how you came to know the Lord.*
Please describe your current walk with God.*
Cross-cultural missions requires a certain level of spiritual and emotional preparedness in order to deal with the inherent challenges, such as coping with cultural differences, working and living closely with teammates, and handling new and possibly uncomfortable situations. Name three people who know you well and could speak to your preparedness for this mission experience.

NOTE: These people may be contacted by leadership at Vista as a reference.
Name, Phone & Email*
Contact Person #1
Name, Phone & Email*
Contact Person #2
Name, Phone & Email*
Contact Person #3
What prompted your desire to go on a mission trip and why do you want to go?*

Activities and Community Involvement
Name Your Home Church*
How long have you been attending your church?*
How are you involved at your church? (small group, children’s ministry, worship team, etc.)*
How are you involved in your community?*
Describe any previous mission experience both in the states and internationally.*
Describe any international travel experience.*

Medical and Psychological Information
Your answers to the following questions about your past do not necessarily disqualify you from Vista missions. Our interest is to see that progress is being made in all areas of your life and that you are ready for a cross-cultural experience. Your answers will be kept confidential.

With travel to other countries and involvement with international organizations working with children, there is a higher level of scrutiny necessary to protect participants as well as those we are serving. If you have any concerns in your background, including any criminal convictions, that we need to know about before traveling to a foreign country, please check the box below so that we can discuss this further with you.
- I would like to discuss my background further.
There are certain challenges unique to international missions experiences that require a level of mental and emotional readiness. Close living quarters, a busy schedule, and team dynamics can be stressful for some. Also, cultural differences coupled with the nature of serving ones who are living in harsh situations can be emotionally difficult. Any of these challenges can possibly trigger any underlying psychological or emotional issues.

In order for us to be able to better help you make the determination of your readiness for a missions trip at this time and to help better prepare you for the experience, we would like to be able to discuss any issues that could arise due to any high-stress situations during your time overseas.

If you have any psychological or emotional concerns in your background that we need to know about before traveling to a foreign country, please check the box below so that we can discuss this further with you. This could include issues such as any addictions, eating disorders, panic attacks, depression, etc.
- I would like to discuss my background further.

Financial Responsibility
Each individual is responsible for his or her total cost of the trip, which is approximately $2,300 for Africa and approx. $2,500 for Cambodia. This includes airfare, lodging, food, transportation, service projects, visa costs and all in-country expenses. This does not include souvenirs or food in airports.

All trip money must be paid in full according to the schedule of payments, or the participant is at risk of losing his or her placement on the trip. If all of the necessary monies are not received and the participant is unable to go on the trip, then the money will be held for the participant for up to one year from the start of the trip applied for. For example, if a participant applied and is unable to go during the summer of 2012, the participant can be considered for the trips during the summer of 2013, and the monies will be held until that time.

  By law, designated charitable contributions must be applied to the purpose that they were given. For this reason, any monies raised and donated cannot be returned to the participant or the donors, but can be held for future use.

  Please make all checks payable to “Vista Community Church.” Checks must note your name in the memo. Contributors will receive a tax-deductible receipt from Vista. Checks should be sent to:  

Vista Community Church - Missions  
6065 Frantz Rd., Suite 205 
Dublin, OH 43017  

AFRICA SCHEDULE OF PAYMENTS
TOTAL TRIP COST: $2,300
March 31st – Total of $500 due
April 30th – Total of $1500 due
May 31st – Total trip cost of $2,300 due

CAMBODIA SCHEDULE OF PAYMENTS
TOTAL TRIP COST: $2,500
March 31st – Total of $1,000 due
April 30th – Total of $1,600 due
May 31st – Total trip cost of $2,500 due

I have read and agree with the Vista Community Church Financial Policy. I understand that payment of the required program fees must be paid in full prior to April 8th, unless otherwise approved by Pastor Mike Smith. I understand that VCC reserves the right to refuse my participation in the mission if my fees are not paid by April 8th and that any partial monies paid will not be returned to me (the participant) or to any donors.
Financial Responsibilities Confirmation:*
- I disagree with these terms
- I agree with these terms
Please Initial*
Initial by typing the three letters of your first, middle, and last name.
Agreement of Parent or Guardian (if applicant is under 18):
- I am under 18 years old and my parent or guardian agrees to these terms
Please Initial
Initial by typing the three letters of your first, middle, and last name.

Trip Cancellation Policy
Download and review Vista’s Trip Cancellation Policy.
Click HERE to view the policy.
Trip Cancellation Policy Confirmation: *
- I acknowledge I have read and agree to the Trip Cancellation Policy
Please Initial*
Initial by typing the three letters of your first, middle, and last name.
Agreement of Parent or Guardian (if applicant is under 18):
- I am under 18 years old and my parent or guardian agrees to these terms
Please Initial
Initial by typing the three letters of your first, middle, and last name.

Release of Liability
I/We do hereby release Vista Community Church, its staff, and volunteer assistants from any and all liability whatsoever arising out of any injury, damage, or loss which may be sustained by said person(s) during the course of their involvement with Vista Community Church.
Release of Liability Confirmation:*
- I disagree with these terms
- I agree with these terms
Please Initial*
Initial by typing the three letters of your first, middle, and last name.
Agreement of Parent or Guardian (if applicant is under 18):
- I am under 18 years old and my parent or guardian agrees to these terms
Please Initial
Initial by typing the three letters of your first, middle, and last name.

Support Raising
Some people have the means to cover the entire cost of the trip, but part of the process is to include others in the mission as well. For this reason, we make it a policy for each participant to attempt to raise funds by reaching out to family and friends. Some people may not be able to raise the entire cost, while others may be able to raise more than the trip cost. As a team, we will work together to raise the total amount needed for all participants. Any funds that you raise over and above the amount of your individual trip will be used towards the total mission trip fund.

As part of your application process, please provide the following. This is to help prepare you for the support raising process. We will use this information during the first team meeting.

You will NOT begin the support raising process until after the informational meeting on February 6th, after you have been accepted.
Please write a rough draft of your support raising letter. (download an example below)*
Download An Example Support Letter.
Download "Writing A Fundraising Letter".
Please submit names and addresses of 10 people whom you plan on sending the letter to. We will not be contacting these people. This is to help you start your brainstorming process.
#1 Name & Address
#2 Name & Address
#3 Name & Address
#4 Name & Address
#5 Name & Address
#6 Name & Address
#7 Name & Address
#8 Name & Address
#9 Name & Address
#10 Name & Address

Mission Trip Agreement
The goal of each mission trip is to love and serve the children and people of Africa and Cambodia. To best accomplish that purpose, participants will be required to attend the informational meeting on February 26th, as well as three additional meetings. During that time we will discuss logistical items, learn about the country and its culture, and plan and organize any games or activities for the children. You may be asked to read articles or prepare materials outside of those meeting dates.

International missions requires an understanding of the cultural and social norms of the country. In order to interact with a high level of sensitivity and understanding, we will adhere to respectful guidelines for behavior and dress that are appropriate for the people we are serving, which may differ from what is typical for western countries. These will be discussed during team meetings.

We will do our best to support you to use your skills, gifts, and abilities while in Cambodia. However, you will also likely be asked to take new steps and to serve in ways that may stretch your level of comfort. As a team, we will work together to serve in whatever area we are needed.

Our schedule for the week will be full as we try to accomplish as much as we can in a short period of time. Teamwork, cooperation, and flexibility are key.

- I have read and understand the conditions above. If I am accepted as a participant, I will attend all required meetings and adhere to the guidelines and schedule for the trip as outlined by Vista Community Church and trip leadership.
Please Initial*
Initial by typing the three letters of your first, middle, and last name.
Once you have submitted your application, you will go to a page that is titled "Thank You for your application". If you do not get to this page that means that your application is not complete and you might have fields that need to be completed. Use the back button if needed.Please make sure it is complete. Then you will receive a confirmation email.

Next, someone from the Missions Team Leadership will contact you to discuss your application. You will be notified of your acceptance status the week of February 20th.

If accepted, you will be required to attend the first informational meeting on Sunday, February 26th, 2012 following church (location TBD)

If you have any questions, please contact Kim Webb at: kim.webb@vistacommunitychurch.org.

Mission Application

Step 1 of 14

Personal Info

Passport Information

Emergency Information

Spiritual Background

Activities and Community Involvement

Medical and Psychological Information

Personal Health Information

Financial Responsibility

Trip Cancellation Policy

Release of Liability

Support Raising

Mission Trip Agreement