Application for Big World Ventures Mission Trip

What to do now!

Fill out this application and follow the instructions on the additional forms
Enclose or Email a recent picture of yourself
Enclose your non-refundable application fee

- $39.00 application fee for those under 21

- ADULTS 21 AND OVER PLEASE INCLUDE A $49 APPLICATION FEE.

Mail completed application and forms to:

BIG WORLD VENTURES

P.O. BOX 703203

TULSA, OK 74170

For more information, please contact us at: 1.800.599.8778 or via email at info@bigworld.org

* Call or email for group and individual discounts

Today’s Date: _____________

Legal Name (As it will appear on your passport, please print clearly)

___________________________________________________________

Address:____________________________________________________

City:___________________________ State: __________ Zip: _________

Home Phone: (_____) __________________________

Church Name:

Church Phone: ( )

Birth Date: Age: Sex: M/F

SS#:

Signature:

E-mail: (PRINT CLEARLY) __________________________________________

My Space or Shout Life: ____________________________________________

T-Shirt Size: _______ This shirt will be sent to you about a month before your trip. Shirts are unisex adults sizes, so please choose accordingly.

Parents/Guardian Information (if under 18)

Father’s Name: ______________________ Mother’s Name: _______________

Phone Number (s): ________________________________________________

Email: __________________________________________________________

If applicable, who has custody of you: _________________________________

Legal Guardian Signature (if under 18): ____

Choose Your Venture:

1^st Choice/Trip Name and Country: ______________________Trip Dates: __________

2^nd Choice/Trip Name and Country: ______________________Trip Dates: __________

3^rd Choice/Trip Name and Country: ______________________Trip Dates: __________

If you are accepted to go on this mission trip, can BWV release your contact information to other accepted mission trip participants so you can begin corresponding before the trip? ___________

Are you fluent in any language (other than English)? If so, please list below:

______________________________________________________________________

How did you hear about Big World Ventures and this mission trip?

________________ ______________________________________________________________________________________________________________________________________

Check which of these best describes you:

___Youth age 12-20 ___ Adult ___Youth Pastor ___Pastor ___Other

General Information

U.S. Citizen?: __Yes __ No

If not a US Citizen please give nationality, visa classification and number:_____________________________________________________________________

Do you currently have a passport? __ Yes __ No

Passport #: ____________________ Passport Country: ____________ Expiration Date: _____

Note: You must have a minimum of 6 months validity remaining on your passport after your trip dates. For example: If you are traveling in July, your passport must be valid until January of the following year.

Have you been on a missions trip before?: __ Yes __ No

If yes, with what group and to what country(ies) and when?: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Do You play an instrument?: __ Yes __ No

If yes, what instrument and are you capable of leading a group in praise and worship, please list your experience?: ________________________________________________________________________________________________________________________________________________________

Self Evaluation:

Please evaluate your personal strengths and weaknesses and attach a number, 1-10 with 10 being the highest, to each attribute.

___Endurance-ability to finish something you started

___Commitment-willing to carry it out to the end

___Self-discipline-can work on a project no matter how you feel and get it done

___Consistent-work well under all conditions

___Relatable-able to relate well with others no matter what the differences

___Communicate-ability to express one’s thoughts, ideas, opinions, ect.

___Organization

___Listening ability

___Problem solving

___Prioritizing

___Leadership

___Follow

___Serve

___Cooperation

___Sense of humor

___Serious

___Balance-Personal life, work, and ministry

___Goal achiever

___Friendly

___Reliable

Personal Background

Have you ever used alcohol on a consistent basis?: ___ Y ___ N

Have you ever used illegal drugs on a consistent basis?: ___ Y ___ N

Have you ever been involved with an occult or a cult?: ___ Y ___ N

Have you ever been expelled or suspended from school?: ___ Y ___ N

Have you ever been in a detention center?: ___ Y ___ N

Have you ever been convicted for committing a crime?: ___ Y ___ N

Have you ever been involved in gang activity?: ___ Y ___ N

Have you ever been in jail?: ___ Y ___ N

Have you every had professional counseling?:___ Y ___ N

If you answered yes to any of the questions above, please explain when was the last time you participated in any of the above and explain your involvement: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Please briefly answer the following questions using a separate page if needed:

1. Please describe your relationship with the Lord (i.e. growing, spiritual influences, Bible study, etc.)

2. Why do you want to go on a mission trip this summer? What was your primary inspiration?

3. What do you think will be your greatest obstacle to going on a short-term venture this summer?

4. How do you practically plan on overcoming your greatest obstacle?

Leaders/Adults (21 years old and over)

This page is a supplement to the general application and is required for your application to be processed.

Vocation/current year of college:

Can you work well under someone else’s authority and enforce the rules established by the Big World Ventures staff-even if things aren’t being run the way you think that they should? (Circle one):

Yes I’m kind of controlling That’s hard!

As an adult on this mission trip, you’re representing Jesus Christ and Big World Ventures. We would much rather err on the side of being too cautious and conservative than too liberal. So, bluntly put…here’s what we expect from you:

v A Godly role model

v Absolutely no smoking, chewing tobacco or drinking (this includes the entire two weeks we’re together—flights, restaurants, etc.)

v No sarcasm (teens are at the point in their development where everything is changing and a simple zit can hurl them into a crisis. This is not the time to get laughs from sarcasm or clever put downs. Your role as a godly leader is to provide positive affirmation and encouragement as well as unconditional love).

v If accepted as a sponsor or leader, you would be with several other adults on a team of up to 30 teens. If the “head team leader” makes decisions you don’t agree with, can you be a team player, or will your attitude reflect that you don’t agree with the way things are being run?

v What is the best way you think God will use you on this trip?

v Do you have any physical conditions we need to be aware of?

v How much sleep do you require per night?_________

v Do you struggle with a sleeping disorder? ___yes ___no

v Are you willing to be flexible (getting up early, having possible last-minute changes, going the extra mile, eating food that might not be your favorite, getting little sleep)?

Yes it’ll be hard, but I’ll do it NO

v Can you maintain a positive attitude when tired or under stress? Yes____ NO____

v Have you ever been convicted of a felony? (Include any plea of guilty or no contest. Exclude minor traffic violations)

YES_____ (If yes, please explain)

Financial Agreement

I understand that my final payment for the total cost of the trip is due to Big World Ventures at P.O. Box 703203, Tulsa, OK 74170-3203 by the final date listed on the payment schedule. I also understand that I’ll need to obtain a passport (if I don’t already have one). I understand that donations made payable to Big World Ventures are tax deductible. If I end up bringing in more than the trip costs, Big World will hold any excess money for one year (12 months) and apply it to another mission trip for me. Donations to Big World Ventures are non-refundable.

I understand the application fees are non-refundable. I also understand the trip cost due to Big World Ventures does not include my round-trip transportation to Miami (or the assigned training city), my passport fees, medical or travel insurance, spending/free day money or departure tax (which is typically around $30, but varies by country). The trip cost is based on 4-6 people to a room, private rooms are available at an additional cost.

PRINT NAME: ______________________________________________

SIGNATURE: _______________________________________________

DATE: _________________

Health History

Name (Please print): ________________________________________________

Have you ever been treated by a doctor for any of the following?

__ Asthma or chronic wheezing

__ Emphysema or other lung and/or respiratory problems

__ Chronic persistent cough or shortness of breath

__ Tuberculosis

__ Any skin disorder or disease other than acne

__ Chronic/recurrent ear or eye problems

__ Impairment of hearing or vision—Meniere’s Disease, cataracts or

glaucoma

__ Persistent, recurring indigestion, stomach or duodenal ulcers

__ Gall bladder stones or colic

__ Jaundice, cirrhosis or other liver problems

__ Intestinal or bowel problems, colitis, diverticulitis, hemorrhoids, other

rectal problems or bleeding

__ Any test results indicating exposure to the AIDS virus

__ Albumin, blood or pus in the urine—painful or frequent urination or

kidney problems

__ Diabetes or hypoglycemia (low blood sugar)

__ Serious bodily injury

__ Mental health counseling or psychiatric treatment

Depression____ Eating Disorder____ Cutting/Self Mutilation _____

__ Rheumatism, gout, arthritis, or other forms of swollen painful joints

__ Chronic back pain, back injury or surgery, sciatica, scoliosis or other bone

or joint disorder

__ Cysts, tumors or growths of any kind, hernia or rupture

__ Cancer

__ Fainting spells, dizziness, convulsions, epilepsy or seizure disorder

__ High blood pressure, heart murmurs or other cardiac problems

__ Vein or circulatory trouble

__ Severe migraine headaches

__ Panic Attacks

__ Goiter, thyroid ailment, high or low metabolism

__ Anemia or other blood disorder

__ Abnormality of reproductive systems, prostate problems, breast disorder,

menstrual disorders or venereal disease

__ Parkinson’s disease

__ Severe knee injury or problems

__ Severe allergic reactions to either food, medicines, bee stings or any other

insect bites

__ Any other disease, deformity or disability not listed above

Family Medical History: Do your grandparents, parents or sibling

have any of the following:

Yes No

__ __ Diabetes

__ __ Hypertension

__ __ Heart disease

__ __ Depression

__ __ Mental illness

If you answered yes to any of the above, please explain who had the illness:

________________________________________________________________

Your last physical exam:

Date: _________________

Name of physician ________________________________

List all the surgical operations or hospitalizations you’ve undergone:

Operation, illness and reason _____________________________________________

_____________________________________________________________________

Date: ______________ Name of physician: __________________________________

Name, city and state of hospital: ________________________________________________________________

________________________________________________________________

Remaining effects: ________________________________________________________________

________________________________________________________________

If you’ve been hospitalized more than two times, please give an explanation:

________________________________________________________________

Please provide any details pertaining to your health not covered by the above

questions:

________________________________________________________________

Childhood Immunizations (must be up to date)

Yes No Type Year

__ __ Mumps/Measles/Rubella ________

__ __ Diphtheria/Pertussis/Tetanus ________

__ __ Polio ________

__ __ Tetanus ________

__ __ Other _______________ ________

* Not sure what vaccinations are required or recommended for the country you are traveling to?? Go to www.cdc.gov to get the official requirements and recommendations. On those recommended by the Center for Disease Control, we suggest you also talk to your family doctor for their feedback and expertise.

Confidential Recommendation

Applicant: Please give the recommendation to your pastor, youth pastor, manager, teacher, or other adult (21+) who has known you for at least one year (not a relative). This confidential recommendation form must be completed and returned to BWV before applicants can be officially accepted to participate in a missions venture.

Applicant’s Name: ______________________________________________________

Applicant’s Phone:______________________________________________________

Reference Name: ______________________________________________________

Reference Email: _______________________________________________________

Reference Phone: ______________________________________________________

Church/School/Company Name: ___________________________________________

Address: ______________________________________________________________

Website:_______________________________________________________________

The purpose of this recommendation is to find out as much as possible about the applicant’s character, fitness and stability. This particular mission trip has a variety of ministry opportunities, team involvement, discipleship, physical demands and spiritual intensity. Therefore, your evaluation is appreciated and held in strict confidence.

Please complete this form and return it within four days to our offices:

Fax: 918-481-5257

Email: venture@bigworld.org .

You can also mail it to:

Big World Ventures, P.O. Box 703203, Tulsa, OK 74170-3203.

1. Relationship to Applicant (i.e. pastor, manager, teacher): _____________________

2. How long have you known the applicant? _____________

3. How well do you know him/her?

___ Not really well ___ Casually ___ Quite well

4. Which of the following best describes the applicant?

E=Excellent AA=Above Average A=Average P=Poor U=Unknown

______ Flexibility ______ Dependability

______ Response to authority ______ Servanthood

______ Spiritual influence ______ Leadership skills

______ Maturity ______ Spiritual life

5. Please check any words that define something we need to be aware of with this applicant:

______ Irritable ______ Procrastinator

______ Inclined to crushes ______ Depressed

______ Rebellious ______ Argumentative

______ Domineering ______ Sarcastic

6. Explain why or why not this applicant should be chosen to participate on this mission trip: ________________________________________________________________________________________________________________________________________________________

7. Please answer the following questions about the applicant’s life:

- Is the applicant active in his/her church? _____________

- To your knowledge, has the applicant had a genuine salvation experience? ________

- To your knowledge, has the applicant’s interest in this mission trip been influenced by a desire to escape a difficult situation such as: family struggles, drug or alcohol abuse or financial struggles? _____________________________________________________

- Are you aware of any medical, mental or emotional illnesses or impairments? _____________________________________________________________________

- Would you consider them to be unstable in any way? __________________________

- Do you have any reason to lack confidence in the applicant? _____________

8. Anything else specific we need to be aware of? ________________________________________________________________________________________________________________________________________________________

This section of the recommendation form is for those 18 years of age and above

1. Please describe your knowledge of the applicant’s experience working in a leadership role with youth and other adults, including strengths and weakness: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

2. Please rate the applicant as a leader in the following areas:

(1 being least, 5 being most – circle one number per area listed)

- High personal moral standards 1 2 3 4 5

- Performance under stress 1 2 3 4 5

- Decision making 1 2 3 4 5

- Relationships 1 2 3 4 5

- Interpersonal conflict resolution 1 2 3 4 5

3. Are you aware of any pending issues or concerns that you feel should be addressed before putting the applicant into any position of leadership? ________________________________________________________________________________________________________________________________________________________

Based on the information above the applicant is recommended for:

small group leader (5-8 people)
large group leader (25-35 people)
neither (but would be an asset to the team and support the leadership)
not recommended at all

Additional Comments: ________________________________________________________________________________________________________________________________________________________

Signature: _________________________ Position: ____________________ Date: _________

Thank you very much for taking the time to fill out this recommendation form!