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VOI - Short Term Mission Trip Application Form

Today's Date
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Your Name (as it appears on your PASSPORT)(*)
Please let us know your name.

First Name - (please retype your first name)
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Last Name - (please retype your last name)
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Title
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Date of Birth(*)
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Age
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T-shirt Size(*)
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Glove Size
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Basic Trip Information

Trip City and Country
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Country and dates not listed above
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Personal Information

Home Address:
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Home City:
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Home State:
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Home Zip:
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Home Phone or Cell(*)
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Your Email(*)
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Passport Number:
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Passport Expiration:
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Special Language Skills:
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Skill Classification
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Nearest Airport:
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Date you plan to FLY TO your mission destination?
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Date you plan to RETURN to your point of origination?
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Special FLIGHT INSTRUCTIONS?
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Church Affiliation:
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Business Information

Business Name:
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Business Address:
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Business City:
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Business State:
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Business Zip:
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Business Phone:(*)
Put your cell or landline contact number.

 

Emergency Contact Information

VOI requires and secures emergency evacuation coverage for each trip participant. The following information will assist us in securing the proper coverage.

Name of Contact Person:(*)
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Phone # 1(*)
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Phone # 2
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Address of Contact Person
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Name of Beneficiary for Traverl's Insurance:
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Relationship to you:
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Health Information

List all medications, allergies, and your reactions to them:(*)
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List all pertinent health information and dietary needs:(*)
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Have you had all appropriate immunizations recommended by the CDC for specified travel area?
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(Please see the CDC website at www.cdc.gov and view the Traveler's Health section for health information about the region you will be traveling in. You are responsible for obtaining CDC recommended immunizations prior to your departure.)

Date of last TB test:
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Results of last TB test
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Vision Outreach International

PERSONAL COVENANT

The guidelines listed below are an essential part of being a guest missionary with Vision Outreach International. By complying with these expectations I will help enhance the sense of community that exists and accomplish the mission’s purpose most effectively. I understand the host country I will be in may not have all the conveniences I am used to at home. For this reason I will strive to be flexible and adjust my personal desires for the sake of ministry. In signing below I accept the following conditions and agree to:


1. Adopt an attitude that I am on this trip to try to understand the host culture, not to convince them of my own viewpoint or style. I go, knowing that there are many different ways to accomplish the same objective, and know that my way is not necessarily the best alternative


2. Guard my language, avoid profanity, insensitive humor, and an argumentative spirit as well as abstain from making derogatory comments about my hosts, their customs, food, manners or ideas.


3. Accept the authority of the Team Leader, missionaries and national host in all decisions. I recognize that they have the team's best interest at heart and I will abide by their decisions without grumbling, meddling or complaining. I understand that travel, especially to remote locations, can be difficult, and I promise to adopt a flexible attitude and be supportive as plans may need to be changed.


4. Understand that my visit is but a tiny speck on the bigger picture of what Vision Outreach is trying to accomplish. I promise not to be overly demanding, to do my best not to offend or cause embarrassment for the local mission host, and to do my best to help them attain their long-term goals.


5. Recognize that the host culture will look at me for an example of integrity, and I will not treat that responsibility lightly.


6. Avoid any actions which might be perceived as amorous attentions toward indigenous people I meet. I will be careful in all conversations or social contacts with nationals and missionaries of the opposite gender. I agree that romantic advances are prohibited.


7. Be sensitive to other by modifying my use of tobacco or alcoholic beverages while in the host country. I will abstain from any illegal drugs or prohibited activity while on this trip.


8. Be guided by the standards of the host in relation to clothing, even if I am uncomfortable.


9. Accept that personal agendas often must be set aside for the well-being of others. Thus, I will clear all personal trips for shopping/tourist activity with the Team Leader/missionary/national host. I recognize that the need for personal safety in a foreign country cannot be taken for granted. Therefore, I agree to never go anywhere without clearing it first,thus limiting my personal freedoms.


10. Not unduly pressure merchants to sell at prices which do not provide a fair return on their product when bargaining for purchases in the shops and marketplaces.


11. Seek guidance from the missionary/national host when I am moved by compassion or kindness to give gifts (whether cash, tools, personal items or things brought from home). I will clear it beforehand with the missionary/national host who will make sure that my good motives fit with the national customs and will not in any way hinder the best interests of the mission.


12. Understand that repeated, willful neglect of the covenant is considered unsatisfactory since it jeopardizes the long term goals of Vision Outreach. If asked to leave because of comprising this covenant, I will return home immediately at my own expense.



OUR VISION

To be followers of Jesus Christ and demonstrate HIS love through the following efforts.

GO - to provide compassionate, high quality care to the blind poor through SHORT TERM Missions.

TRAIN - to transfer skills by training other both nationally and internationally.

EDUCATE - to educate ourselves and others on the best tools for international work.

NETWORK - to advocate for the blind poor by networking with like-minded medical professionals, mission agencies, and international partners.

By checking "YES, I agree" below, You hereby attest that the information provided above is true and you are the individual whose name appears on the first line (NAME) of this form.

Furthermore, by clicking "YES, I agree" below you agree to abide by the personal covenant and you agree to release Vision Outreach International, Inc. (VOI) of all liability pertaining to your involvement in the above mentioned mission trip. You have agreed to participate in this trip voluntarily and understand the risks involved in this type of work and international travel.

If you agree with these statement, please click, "Yes, I agree"

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Other Information or questions?
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