Name *
Phone *
Address *
Birthday *
Do you have a passport? *
Emergency Contact Phone Number *
Emergency Contact Phone Number
Could you give us some insight into these areas? Have you been involved in any of the following areas? If so, please explain the circumstances briefly, comment on your current position with each of these areas, how long it has been since you have participated in these, what ministry you have do to overcome them, and what level of freedom you are walking in now. we realize that the following questions are personal. Please be assured that all answers are held in strict confidentiality.
Please note on mission trips, special dietary needs normally are not able to be met. We still want to know what your dietary needs are and will try to be accommodating as possible.
This may not preclude you on certain trips but will on other types of trips.
Health Agreement (READ DESCRIPTION) *
By submitting this application, in case of emergency, you hereby agree to the performance of such treatment, including anesthesia and surgery, or any other treatment that an attending doctor or physician may deem necessary. You agree to meet any and all medical expenses that are incurred during the course of involvement with A Called Generation, and it’s partners. You also do hereby release A Called Generation, Inc., it’s departments, partners, staff, agents and volunteer assistants from any liability whatsoever arising out of any injury, damage or loss sustained by said persons during the course of involvement with A Called Generation Inc.
Please check all of the following that apply to you *
Please check all areas of expertise that apply to you *