Fellowship of Christian Farmers
On-Line Mission Trip Application

* Indicates required field

*Name                 *Age 

*Address  

*City         *State/Province   *Zip 

*Country      *Email Address 

*Home Phone       Work Phone 

*County/Province of Birth 

*Languages Spoken or Read 

Vocal Ability:  
Solo
Group
Choir

Further Description of Vocal ability (optional) 

Date of Last Physical Describe Health Good Fair Poor

Do you wear contact lenses? Yes No

Do you have any handicaps? Yes No If 'Yes' explain

Are you presently taking any medication? Yes No If 'Yes' explain

Skills/ Experience:

Explain how you feel your skills, hobbies and professional training can be
beneficial on an overseas mission field:
Also indicate the name of local newspaper/TV?radio that may run a story about your mission trip

Overseas travel requires a passport. Do you have a passport? Yes No

Passport Number Issued where When

List all previous overseas field experiences below:
Field Project/Crusade and Dates

First Choice Jamaica Group 1- February 7-21, 2008 Jamaica - one week February 7-14, 2008 Albania Group 1 - Jan 15 - 29, 2008 Albania Group 2 - Feb 5 - 19, 2008 Mexico (Williamson) Grp 1 - Jan 4-12, 2008 Mexico (Gomez) Grp 2 - February 1-13, 2008 Mexico (Gomez) Grp 3 - February 22-Mar. 4, 2008 Russia Group 1 - March 25-April 7, 2008 ISRAEL - March 24 - April, 5 2008 Burkino Faso, West Africa - January 2008 Greece - February 29-March 13, 2008

Second Choice Jamaica Group 1- February 14-21, 2008 Jamaica one week February 7-21, 2008 Albania Group 1 - Jan 15 - 29, 2008 Albania Group 2 - Feb 5 - 19, 2008 Mexico (Williamson) Grp 1 - Jan 4-12, 2008 Mexico (Gomez) Grp 2 - February 1-13, 2008 Mexico (Gomez) Grp 3 - February 22-Mar. 4, 2008 Russia Group 1 - March 25-April 7, 2008 ISRAEL - March 24 - April, 5 2008 Burkino Faso, West Africa - January 2008 Greece - February 29-March 13, 2008

When this form is completed a payment page will open, allowing you to immediately pay for the first choice you selected above. FCFI has selected PayPal to insure the security of the online credit card transaction. (Mastecard, Visa, Discover, American Express) If you do not pay online, then this application will not be considered until we receive your check in FCFI's home office.(Address on payment page)

 

Name Phone

Address

City State Zip

Foreign travel by its very nature offers an unfamiliar and unique environment, and the risks for injury to both persons and property are inherent. I understand that by my participation in an FCFI crusade I am indicating my acceptance of these risks.

In consideration of my being accepted on an FCFI crusade, I (type your full name here) * hereby voluntarily release the Fellowship of Christian Farmers, International, Inc. and each of its employees, trustees, and agents of the negligent or other acts or omissions of FCFI, its agents or employees.

I further agree to indemnify FCFI and each of its employees, officers, and agents for any expenses or costs resulting from these acts or omissions, or resulting in anyway from my participation in an FCFI crusade, including my own negligence. I am aware that basic accident insurance coverage is provided as part of the FCFI crusade program, but that this insurance may not cover all situations.

Furthermore, I understand that there is no personal property insurance provide through the FCFI crusade program, and that such insurance is considered a personal responsibility of the FCFI crusade program participant.

If you agree to all of the above terms, type the words "I ACCEPT" here:
*