Mission Trip Registration

MM Senegal 1/22

This ministry trip is about building relationships and teaching English to Muslim college student. This team will be able to witness to the Muslim student under the umbrella of teaching them English. This trip will take place January 21-31, 2022. For more information please feel free to contact the team leader, Keith Anderson, keith.anderson@bethlehem.church.
1/21/2022 - 1/31/2022

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.