Contact Information (Please fill in your name as it appears on the ID you would use at airport security.) |
| Name: |
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| Address: | | City: | |
| State: | | Zip: | |
| Home/Cell Phone: | | Email: | |
| DOB: | | Age: | |
| Shirt Size: | | Gender: | Male Female |
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Church Information |
| Name of church affiliation if not a member of GHBC: |
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| Church Phone: |
| Pastor: |
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Health Information |
| Condition of health: Excellent Good Poor |
If you have had major heart problems or surgery, please explain:
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| Are you on medication? | Yes No
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| If yes, what kind? |
| Allergies: |
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| Can you travel by plane? | Yes No
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Experience |
| Please check any areas you have experience in: |
Carpentry
| Mechanical
| Construction | General Maintenance
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Plumbing
| Electrical
| Masonry
| Painting
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Food Prep
| Other
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| Are you able to do manual labor for an 8-hour period? Yes No |
| Which week are you able to participate on this project? 1st 2nd 3rd 4th Where Needed |
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Spiritual Qualifications |
| Are you actively involved financially in the missions program of your local church? Yes No |
| How long have you participated? Years: Months: |
| Is there anything in your testimony that would disqualify you from being a representative of CLAMP on this missions trip such as drinking, smoking, chewing, etc.? Yes No |
| If you were not included in this team due to numerical limitations, would you be willing to be a part of another week or the next CLAMP missions trip? Yes No |
| Do you attend all the services of your local church regularly if not providentially hindered (sickness, work, etc.)? Yes No |
The priority for asking people to participate has been:
1. Spiritual Qualifications
2. Length of involvement in missions programs
3. Health Status
4. Experience and ability in skilled labor
5. Availability
The remaining spots on the term will be filled based on the same priorities and the completion of this intent form. We realize that there are a good number of qualified and capable men that cannot go for various reasons and obligations. We seek to fill all positions as the project dictates and skills are required.
Please contact us at 757-482-1177 or [email protected] with any further questions.
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