Mission Trip Registration

MM Uganda 10/20

The team will be ministering to people with disabilities and their extended families through distribution of wheelchairs, participation in activities in local churches, and possibly work in a refugee camp. Physical therapists, mechanics, and anyone with experience seating or working with wheelchairs are particularly desired. Bob Horinging is leading this ministry trip, his email is horning.bob@gmail.com
10/16/2020 - 10/31/2020

Additional Information

We are so glad that you are interested in going on a short-term ministry mobilization (STMM) trip! We pray that God will use it to proclaim His glory among the nations and to spark a passion in your heart for His global mission!


All who are sent out on a STMM trip by Bethlehem must complete this application. Completion of the application is no guarantee of financial support or acceptance to a particular team.


Please note: There is a $75 application deposit that is required to be submitted along with this application. If your application is approved, this will be credited towards the amount of support that you need to raise for the trip. The application deposit is non-refundable, unless your application is not approved. If your application is not approved, your deposit will be refunded.


Thank you for taking the time to fill out this application! You will be contacted by the Global Outreach Department once your application has been processed.


For the joy of all peoples,


- Bethlehem Global Outreach Department

*Date of Birth:
*Emergency Contact Name:
*Emergency Contact Email:
*Emergency Contact Phone:

*Health Insurance Provider:
*Health Insurance Policy Number:
*Blood Type:
*List any medical conditions or restrictions.:
*List any medications you are currently taking.:
*List any allergies you have (including food).:
Please provide the requested personal information below.

*Please describe any prior experience outside the US.:
*Describe some of your strengths and weaknesses.:
*List 3 people at Bethlehem (pastor, small group leader, or member) who could serve as a reference for you.:
*Why do you want to participate in this trip?:
*What ministry do you plan to be doing on this trip?:
*Please indicate if you are interested in leading this trip.:


*Do you have a passport?:
Full Name as shown on passport:
Passport Number:
Passport Date of Issue:
Passport Expiration Date:

*Describe how you came to trust Christ as your savior.
*How would you articulate the gospel to a non-believer?
*Why should Christians be involved in cross-cultural missions? What is the goal of missions? How does this particular ministry trip align with the goal of missions?

Please review Bethlehem's Congregational Affirmation of Faith before answering the next question.

*Are you in full agreement with Bethlehem's Congregational Affirmation of Faith? If not, please list any points of disagreement.
*I understand that my $75 application deposit is non-refundable unless my application is not approved.