Instructions: Fill out this application and send it to linda.solarek@gmail.com along with a copy of your passport photo. Please go to www.tranformationofthenations.com to make a $150 non-refundable deposit to the “Transformation of the Nations” office. If you want to pay by check, please mail to address below. You are not officially on the trip until a deposit is made. The trips do fill up and usually are limited due to vehicles and housing arrangements. All documents will be secure and kept confidential.

TOTN MISSION TRIP CONTACT:

Email: linda.solarek@gmail.com
(Please scan and send the application and you will receive a Paypal invoice for the deposit)

Mailing of checks:
Transformation of the Nations
c/o Linda Solarek
3350 SW 108th Ave
Beaverton, OR 97005
Phone: Linda Solarek, 503-407-9203
Fax: 503-265-5936

PERSONAL INFORMATION:

name date of birth (exactly as it appears on your passport) mm/dd/yy
nickname (or name you go by) age gender malefemale
occupation
marital status marriedsingle
street address
city state zipcountry
home work
fax cell
email

MISSION TRIP INFORMATION:

i am applying for the him trip to
destination (city, country)
on the dates of

MISSION TRIP APPLICATION

passport number expiration date
country of issue
preferred airport of depature city alternate airport

REFERENCE INFORMATION:

pastor’s or ministry leaders name phone
other reference phone

EMERGENCY CONTACT INFORMATION:

emergency contact name relationship
email address phone number

MISSION TRIP BACKGROUND INFORMATION:

have you perviously traveled with him on a mission trip? yesno if yes, give
location and dates
are you willing to minister according to him’s values and guidelines yesno
how would you describe your personality and temperment?
are you fluent in any languages than english? yesno if yes, what
language would you be willing to be a translator if
applicable? yesno
what do you desire to see god do for you and through you on this mission
trip?

MINISTRY BACKGROUND INFORMATION:

do you attend church regularly yesno
have you been baptized? yesno
in what areas of church life are you currently serving or have served in the
past?
what do you believe are your spiritual giftings?
have you received any other christian ministry training? yesno if so, please
explain
have you ever been placed on probation or have asked to be released from
ministry? ? yesno if so please explain

CHURCH AND MINISTRY INFORMATION:

name of church and/or ministry
denomination and/or apostlic affiliation, if any
address
city state zip
phone fax email

MEDICAL AND INSURANCE INFORMATION:

do you have any physical disability? yesno if so, please
describe

have you ever been treated for any mental/emotional condition? yesno if
so, please describe

please list any condition that may limit your participation any medications
you are currently taking

please list any allergies to food, medicine, etc.
do you have primary medical insurance yesno if so, what is the name of your
insurance carrier?
i, , hereby confirm that i’ve prayed and sought counsel about going on this missions outreach. by signing this waiver, i promise to uphold godly values while on this trip and to submit to leadership and those responsible for my safety. i also acknowledge that i am in good physical and emotional health, and will not hold harvest international ministry, hrock church, or transformation of the nations and their employees or agents liable for any harm, sickness or injury to me that may result from this trip. i will check with my doctor and make sure that all my vaccinations are up to date. i will obtain a valid passport and necessary visas when necessary. i also understand that the price may change due to airfare increases and departure city. i know that the application is not complete until this waiver is signed and a deposit is received.

signed date