Missions Application Form

Personal Details

Check all applicable boxes;

Medical and history


Please give 3 referees one whom must be your church leader. All references should have known you for at least 1 year. Please do not use any friend who is your peer or any family member as a reference.

Reference 1

Reference 2

Reference 3

The cost of your trip is dependent on the length of your stay in country, plus a one-time administration fee of $100. Please note that checks made out to Hope and Care are ultimately donations. Due to this, we cannot refund money for these trips if you must cancel. We can set aside your donation if you want to postpone your trip to another time.