GAP Mission Team Member Application

GAP Mission Team Member Application

Application Date: Location & Trip Dates: Personal Information Name: Last First Middle Street Address City: State: Zip Code: Home Phone: Cell Phone: Email: Gender: ( ) Male ( ) Female Date of Birth: Marital Status: Single Engaged Married Widowed Separated Divorced If Married, Spouse s Name: If you have children: Child s Name Age Gender Occupation: Relationship to Heartland Church Check the appropriate boxes and complete the requested information. Member since (month/year) and/or have attended since (month/year). Member of a church other than Heartland Church. Specify church:. Do you regularly attend a Sunday school class? ( ) Yes ( ) No I attend a Community Group or small group. Please list your leader s name and how long you have attended: I actively serve in other ministries. Please list the ministries:

Abilities & Skills Do you have any special skills or gifts (sing, dance, paint, construction, sewing, crafts, etc.)? Spiritual Information & Mission Experience Describe your personal relationship with Jesus Christ. Why do you want to serve on this mission trip? What expectations do you have for this trip? Have you served on other mission trips? ( ) Yes ( ) No If yes, where? If yes, what impact did it have on you?

Registration To complete registration, the following MUST be submitted by the registration deadline (applications received after the deadline will be put on a waiting list): GAP Mission Team Application $50 non-refundable/non-transferable deposit (*If you are denied travel status with this specific team, your deposit will be refunded.) If you are under the age of 18, please attach two letters of recommendation. These letters serve as references to your spiritual maturity, personal development, and community experience. Only one letter can be written by a Heartland Church pastor; the other letter should be written by another leader in your life (teacher, coach, youth leader, etc.). Payment Schedule $50 non-refundable/non-transferable deposit due at time of registration. 50% of the cost of your trip is due to the GAP Missions Department by the first payment deadline. 75% of the cost of your trip is due to the GAP Missions Department by the second payment deadline. Remaining balance is due to the GAP Missions Department by the final payment deadline. Contributions will not be accepted 14 days prior to departure. Any outstanding balances will be handled through your team leader. Personal fundraising for trip support should begin immediately AFTER the first team meeting. The following language should be included in support letters: Please make check payable to Heartland Church and include appealed by (team member s name, trip location, and date) in the memo line. Your check will provide Heartland Church with all necessary information to send you a receipt for your tax records after the end of the year. They request you send all donations by (insert date of first payment deadline). Heartland Church is registered with the IRS as a 501(c)3 non-profit organization. Donors will receive receipts for their gifts with the understanding that the disbursement of those gifts lies completely at the discretion of Heartland Church and that gifts are nonrefundable and non-transferable per IRS regulations. If you have questions concerning this process, please contact the Heartland Global Missions Department at 270.534.1400. Any amount received in excess of the trip cost will be used for other team expenses or transferred to the GAP Mission offering. *No refunds will be given. Expenses, Changes & Cancellations Expenses will not be paid unless there are adequate funds in your trip account. Any changes in registration information/expenses or cancellations must be communicated with the GAP Missions Department staff immediately. The trip cost will be adjusted accordingly if necessary. Additional expenses incurred while on the trip are NOT covered by Heartland Church. All team members are encouraged to take additional funds to cover road meals.

GAP Missions Financial Policy It is the desire of the GAP Disciple-making Staff to be good stewards of the finances we have been entrusted. These policies were developed with that desire in mind. Mission Team Leaders are responsible for communicating these policies to team members and ensuring adherence to the payment schedule. Please make checks payable to Heartland Church and include appealed by (team member s name, trip location, and date) in the memo line. *Only checks including this information can be considered tax deductible. Personal checks from the team member can be mailed to Heartland Church, ATTN: Alicia Turner; 4777 Alben Barkley Drive; Paducah, KY 42001. Support checks MUST be mailed to the team member applying for assistance. The team member can turn the checks into their team leader or the GAP Missions Department during business hours (M-F, 8:30 AM - 4:30 PM), or mail them to Heartland Church, ATTN: Alicia Turner; 4777 Alben Barkley Drive; Paducah, KY 42001. (*Please do NOT put these checks into the offering plate or box.) Disclaimer Please initial in the space provided as indication of understanding and agreement of the statements: Heartland Church will NOT be responsible for extra trip expenses. Should these occur, they will be passed along to the traveler. I agree to return home at my own expense if the team leader, in conjunction with the GAP Missions Department, determines my behavior is/has been inappropriate and, therefore, jeopardizing to the ministry. I understand my involvement on this trip can be denied prior to travel in the event I do not participate in the full preparation of the trip (i.e., team meetings, fundraising, etc.), thus compromising the effectiveness of the trip. In submitting this application: I express my agreement with Heartland Church s vision, mission, goal, values, and beliefs. I am willing to travel under the direction of the GAP Missions Department, Team Leader, and Field Partners, and to perform assignments with a God-honoring attitude. I agree to be subject to a background check. I confirm that I have time and energy to devote to the pre-, mid-, and post-trip responsibilities, including team meetings and all requirements necessary for the trip. I have read and agree to the above deposit and payment information, along with the financial guidelines described in Heartland Church s Mission Trip Financial Policies. Signature Team Leader Signature Date Date