Belize Application

First Name *

Middle Initial

Last Name *

Email *

Address *

* Please include mailing address if different from above.

Home Phone *

Work Phone

Fax

Nationality *

Date of Birth *

Month - Day - Year

Are you? *

Single

Married

Divorced

Present Occupation

Do you have any health problems, disabilities, emotional disorders, allergies, or are you restricted in your physical activities in any way? *

Yes

No

Please Explain

When did you become a Christian and what were the circumstances? *

When and where were you baptized? *

Name and address of your home assembly *

Have you discussed your application with your elders and what is their response? *

Please list the names and telephone numbers of two of your assembly elders *

In what ways are you presently actively involved in your home assembly? *

In what other ways have you served the Lord in the past? *

What special gifts, talents, abilities or training that might be helpful to the team program? *

Why do you want to serve the Lord in Belize this winter and what personal goals do you have? *

Do you have any particular concerns in relation to serving the Lord in Belize this winter? *

Are you prepared to do without the comforts of home and to accept the differences in climate, custom, culture, etc. which you will find in Belize? *

Yes

No

Are you willing to work under the direction of the Belize assembly elders and your team leader? *

Yes

No

I would like to serve the Lord in Belize with eTeams

March 11 to 25, 2015

By submitting this application:

• I affirm that the facts set forth in it are true and complete. 
• I understand that if I am accepted as a volunteer, any false statements, omissions, or other misrepresentations made by me on this application may result in my immediate dismissal. 
• If accepted, I will respect the decisions and authority of team leaders and of the missionaries serving in Belize. I will not hold Tim Hood, Sean O'Byrne or any member of eTeams organizations responsible for any accident which may occur or any ill effects which may arise as a result of my involvement in this short term mission. My participation is at my own risk and neither Tim Hood or anyone from eTeams is responsible for my welfare.

I agree to the above statement *

Yes