GO Trip Application

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GO Trip Application

Full Name (Required) *
- First Name
- Last Name
Your Email Address (Required) *
*IF SUBMITTING MULTIPLE APPLICATIONS YOU MUST USE A UNIQUE EMAIL FOR EACH ONE *
Do you agree to take a COVID-19 test immediately before the GO Trip begins? *
Do you agree to abide by all of the country's vaccine and health guidelines and requirements for entry? *
Trip applying for: *
Your Address *
- Street address
- Street address 2
- - City
  - State / Province
- - zip code
  - Country
Mobile Phone *
- -
  Area Code
- Phone Number
*No spaces or special characters when entering phone numbers.* (i.e. 408 1234567 )
Home Phone *
- -
  Area Code
- Phone Number
Work Phone *
- -
  Area Code
- Phone Number
Gender *
- Male
- Female
Date of Birth *
- Month
- Day
- Year
Emergency Contact Name *
- First Name
- Last Name
Emergency Contact Phone *
- -
  Area Code
- Phone Number
*No spaces or special characters when entering phone numbers.* (i.e. 408 1234567 )
Emergency Contact Relationship *
Emergency Contact Email *
(Passport Required for International Trips Only)
Passport Number *
Passport Expiration *
- Month
- Day
- Year
Name on Passport *
T-Shirt Size *
Will you be bringing a child? *
If YES, Please list child(s) name as on passport with DOB passport number & expiration.. *
Medical Insurance
Medical Provider *
Policy Number *
Contact Number *
International Insurance *
- Yes
- No
- Maybe
Allergies/Medical conditions: *
Current Medications *
Pastoral Reference
Where do you attend church? *
How long have you attended there? *
Pastoral reference name *
Email/phone number *
Criminal History
Have you ever been convicted of a crime? *
- Yes
- No
If yes, please explain *
Have you ever been arrested? *
- Yes
- No
If yes, please explain *
Have you ever been convicted of a DUI? *
- Yes
- No
If yes, please explain *
GO Trip Questionnaire (Please answer carefully, and give your answers thought.)
Are you a Christian? *
- Yes
- No
If you answered YES please continue, if you answered NO, please skip to the "Past Trip" Section
If you attend WestGate, Are you six40 disciple? *
- Yes
- No
How long have you been a Christian? *
How did you come to know the Lord? *
Describe your current relationship with Jesus: *
Past Trips
Have you ever been on a mission trip? *
If yes, where to? *
What activities were you involved with on previous missions trips you were on? *
This Trip
Why do you want to participate on this trip? *
Do you have any concerns about going on this trip? *
- Yes
- No
If yes, please explain: *
Gifts and Talents
Do you speak any other language other English? *
- Yes
- No
If yes, what language? *
How fluent are you? *
Do you play any musical instruments: *
- Yes
- No
If yes, which instrument? *
Do you have medical experience? *
- Yes
- No
If yes, what: *
Other: *
Do you have construction experience? *
- Yes
- No
What areas? *
Other: *
Share your spiritual gifts, strengths or talents? *
Occupation
What do you do for a living? *
Do you have this time approved to be off from work? *
- Yes
- No
- Pending/In Process

GO Trip Application

IF SUBMITTING MULTIPLE APPLICATIONS YOU MUST USE A UNIQUE EMAIL FOR EACH ONE

No spaces or special characters when entering phone numbers. (i.e. 408 1234567 )

No spaces or special characters when entering phone numbers. (i.e. 408 1234567 )

Medical Insurance

Pastoral Reference

Criminal History

GO Trip Questionnaire (Please answer carefully, and give your answers thought.)

If you answered YES please continue, if you answered NO, please skip to the "Past Trip" Section

Past Trips

This Trip

Gifts and Talents

Occupation

GO Trip Application

*IF SUBMITTING MULTIPLE APPLICATIONS YOU MUST USE A UNIQUE EMAIL FOR EACH ONE *

*No spaces or special characters when entering phone numbers.* (i.e. 408 1234567 )

*No spaces or special characters when entering phone numbers.* (i.e. 408 1234567 )

Medical Insurance

Pastoral Reference

Criminal History

GO Trip Questionnaire (Please answer carefully, and give your answers thought.)

If you answered YES please continue, if you answered NO, please skip to the "Past Trip" Section

Past Trips

This Trip

Gifts and Talents

Occupation

IF SUBMITTING MULTIPLE APPLICATIONS YOU MUST USE A UNIQUE EMAIL FOR EACH ONE

No spaces or special characters when entering phone numbers. (i.e. 408 1234567 )

No spaces or special characters when entering phone numbers. (i.e. 408 1234567 )