2 |CCH Haiti Mission Trip 2015

Dates: Friday, May 8 – Thursday, May 14, 2015

Location: Cercady, Haiti (with The 410 Bridge)

Application due Sunday, November 9 to Elise

*Fill in the gray areas of the form. Email completed application to . Hard copies upon request.

Full Legal Name:

Phone:

Year in School: Major: Do you have a passport? Yes No

Have you ever been on a mission trip? Yes No If yes, please indicate where and what you did.

Briefly describe why you want to go on the Haiti trip:

Briefly describe ways you currently minister to other people (not positions or titles you have). For example: “I minister by being a trusted listener for people going through hard times” or “I minister to people by inviting them for dinner to get to know them” or “I do behind-the-scenes tasks for our fellowship/church,” or “I minister to people by taking time to pray with them for their needs,” etc. etc.

Have you had any experiences, roles, or settings where you interacted with someone from a very different cultural or ethnic background than yourself? (ie – EIU Conversation Partners, helped teach English to immigrants, other mission trip, etc., etc.) If so, please describe.

Describe your interpersonal relationship skills. How do you get to know new people? How easy/hard is it for you to build significant relationships with new people?

How do you tend to react in stressful situations (like interpersonal conflict, things not going as planned, etc)?

Describe your willingness to engage in activities that are new or different than you’re used to.

Check all of the following that you would be willing to participate in on the Haiti trip (Please note: You will not be asked to perform labor that requires extensive training & knowledge such as wiring/electrical, structural design, etc.):

Eating new, unfamiliar foods Long walks/hikes (45 minutes or so)

Maintenance/Cleaning Visiting Haitian homes

Helping create/teach English camps Preaching/teaching in a church setting

Construction help or other manual labor Spending time playing with children

Sharing Devotions w/410 Staff and/or CCH Team Spending time getting to know Haitian adults

Sharing your personal testimony with the team Long & bumpy car rides

Attend town meetings with villagers (to hear their community’s goals & long-term development dreams)

Do you have any health-related issues that could be of concern on this trip? Yes No
If yes, please explain.

Have you ever considered serving on the mission field as a career missionary? Yes No
Explain if you desire.

Are you open to going to another mission field this school year other than Haiti? Yes No
Explain if you desire.

On a scale of 1 to 10 with 1 being least sure and 10 being most sure, select how sure you are that you want (and if selected, will commit) to go on the Haiti trip this coming May?
Explain if you desire.

Once your application has been received, you will be contacted to meet with the team leader to discuss your application, details of the trip, and expectations for team members. You will have the opportunity to discuss questions, concerns, or other topics you have that are related to the trip.

If there’s anything in particular you already know you’d like to discuss with the leader (questions, comments, concerns), feel free to write those here:

When complete, save as “Haiti e-Application 2015, Your Name” & email to