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APPLY ONLINE - GENERAL INFORMATION FORM:
Please include the following items to complete your application:

1. General Information.
2. Pastoral Confirmation of support, please submit online by your church pastor, campus staff or small group leader.
3. If you are under age of 18, please submit online by your parent/guardian for the Parent/Guardian Consent Form.
4. Application fee US$20. (Check only, no cash please) Please make check payable to " Overseas Summer Missions". Also, email us a personal photo for our file use.

Please mail your check to:
Overseas Summer Missions
2222 Michelson Drive, Suite 5220
Irvine, California 92612
If you have any questions regarding the application forms or projects, please feel free to contact us.
Email: francis@ITPSusa.org
TO THE APPLICANT: These forms will complete your initial application for the volunteer project. If you are under age of 18, please also complete the Parent/Guardian Consent Form. Although this office does not guarantee the acceptance, we do encourage you to pray for God’s leading and submit your application, we will make an effort to place the applicants according to their desired mission field. God bless you!


GENERAL INFORMATION FORM:
Date of Application:
First Preference - Country:
 Weeks:
Second Preference - Country:
 Weeks:
Name of Church or preferred denomination to be assigned to, if any.

Mission cost: 

Name of Applicant:
Date of Birth:
Place of Birth:
Citizenship:
Gender:
Male     Female
   
Have you applied for any OSM missions before?
YES     NO
If yes, how many times have you applied for the missions:
What country did you go with OSM (if any) for your previous missions:
   
Current Address:
City:
State:
Postal Zip Code:
E-Mail Address:
Home Phone:
 () - Ext:
Work Phone:
 () - Ext:
   
Passport Number (If available):
Passport Expiration Date:
   
Marital Status:
Single       Engaged       Married       Divorced       Widowed
   
Have you ever been convicted of a felony or misdemeanor?
YES     NO
   
Emergency Contact:
Relationship To You:
Emergency Contact Home Phone:
 () - Ext:
Emergency Contact Work Phone:
 () - Ext:
   
Your Occupation:
School Attending or Graduated from:
Education (Years):
College (Years):
Postgraduate (Years):
Major:
   
Special Skills:
Music     Lead Singing     Nursing     Medical     Computers
Other Special Skills:
Specify Instrument If Music:
Finance:
Self-Support     Partial Fund Raising Required
   
Name of Church attending:
Email:
Pastor’s Name:
Church Phone:
 () - Ext:
Church Address:
City:
State:
Postal Zip Code:
   
The names of your close friends also applying (if any):


   


REFERENCES:
List three references, their address, phone numbers, and number of years (minimum one year) you have known each reference. Please do not include relatives.
Reference 1 - Name:
Years Known:
Address:
Phone:
 () - Ext:
Email:


Reference 2 - Name:
Years Known:
Address:
Phone:
 () - Ext:
Email:


Reference 3 - Name:
Years Known:
Address:
Phone:
 () - Ext:
Email:
   


 


HEALTH QUESTIONNAIRE:
Short-term missions can be exciting and inspiring; they can also be strenuous and stressful. There are many factors that can aggravate certain health conditions, and the medical facilities in some countries where we travel may not provide timely and adequate care. Your health and safety is our primary concern. If necessary, we may request a medical release from your doctor.
General Information - Height:
 Feet Inches
Weight:
 lbs.
Have you been in good health most of your life?
YES     NO
Have you had any serious illnesses?
YES     NO
If yes, please explain:
Allergies:
Medications:
   
All applicants must refrain from using any alcohol or tobacco while serving overseas.
   
HEALTH QUESTIONNAIRE CHECKLIST
  
   
Respiratory:
  
Asthma or wheezing:
YES     NO
Difficulty breathing:
YES     NO
Any trouble with lungs:
YES     NO
   
Cardiovascular:
  
Chest pain, pressure or tightness:
YES     NO
Difficulty walking two blocks:
YES     NO
Shortness of breath when walking or lying down:
YES     NO
Heart murmur:
YES     NO
   
Head-Eyes-Nose-Throat:
  
Impaired hearing:
YES     NO
Transient episodes of unconsciousness:
YES     NO
   
Hematological:
  
Are you slow to heal after cuts:
YES     NO
Blood disease:
YES     NO
   
Neuro-Psychiatric:
  
Have you ever had counseling for your mental health:
YES     NO
Convulsions:
YES     NO
Paralysis:
YES     NO
Problems with coordination:
YES     NO
   
Phobia:
If you have any phobias or other medical problems, please describe:
  
   
Are you currently receiving benefits from any government disability program? If yes, please explain:
   
 


SPIRITUAL QUESTIONS:
1. Please briefly describe how and when you trusted Christ as your Savior.


2. Are you involved in any student ministry on campus?
Campus Crusade For Christ:
YES