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Short Term Mission Trip Information & Application Packet

2011-2012

ContentsContentsContentsContents

About About About About HOCIHOCIHOCIHOCI | page 2| page 2| page 2| page 2

How to Apply | page 3How to Apply | page 3How to Apply | page 3How to Apply | page 3

Frequently Asked Questions | page 4Frequently Asked Questions | page 4Frequently Asked Questions | page 4Frequently Asked Questions | page 4

2011201120112011 Calendar and Locations | page 5Calendar and Locations | page 5Calendar and Locations | page 5Calendar and Locations | page 5

Form 1012A Application | page 7Form 1012A Application | page 7Form 1012A Application | page 7Form 1012A Application | page 7

Whom shall I send?Whom shall I send?Whom shall I send?Whom shall I send? And I heard a voice from the Lord

saying, “Whom shall I send, and who

will go for us? Then, I said, “Here am I! Send me”.

Isaiah 6-8

…………repentancerepentancerepentancerepentance and forgiveness of sins and forgiveness of sins and forgiveness of sins and forgiveness of sins should be proclaimed in his name to should be proclaimed in his name to should be proclaimed in his name to should be proclaimed in his name to

aaaall nations…ll nations…ll nations…ll nations… Luke 24:47Luke 24:47Luke 24:47Luke 24:47

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AAAbbbooouuuttt HHHaaannndddsss ooofff CCCooommmpppaaassssssiiiooonnn IIInnnttteeerrrnnnaaatttiiiooonnnaaalll Our MissionOur MissionOur MissionOur Mission Hands of Compassion International, LLC exists to assume the God given responsibility as being the hands of Jesus Christ through facilitating and managing short term missions and building communities of compassion going into the entire world with the gift of Compassion and proclaim the Good news of Him who gives eternal life while making disciples of people of all nations.

A. Short Term Mission Trips: Through short term missions, we will strive to bring awareness to the local church in the United States of the conditions around the world hoping to rise folks up from our comfort zone to go on mission for God. We feel that this experience will personally change the hearts and attitudes of Christians everywhere, thus causing them to worship our living Savior and commit to being completely sold out to Him.

B. Orphan Care: As churches and Christians get on the mission field, opportunities will

be available and taken advantage of through the ministry of Hands of Compassion International to get involved in the world wide orphan epidemic. We feel the Lord’s compassion for children is of utmost importance, and this ministry will get on board with other agencies and/or take sole responsibility, if available, to care for these beautiful children through sponsorship programs, construction of orphanage buildings, Christian education for the kids, food, clothes, disaster relief, etc.

C. Communities of Compassion: We desire partner with national pastor’s and leaders to

build communities in the most desolate are poverty stricken areas of the world for the purpose of promoting education and providing much needed food, health care with the intent that the entire city or village someday be self-supporting and successfully operating from within. These communities may consist of children’s homes, medical centers, schools, churches, etc.

Our ValuesOur ValuesOur ValuesOur Values

� Faith in Jesus Christ as the only way to eternal salvation � The Bible in its entirety as the only true revelation of God � Personal devotion to Christ in all areas of our lives � Faithfulness to spread the love of Christ to all people � Openness to the work of the Holy Spirit in our lives � Respect for all people in all our actions and attitudes � Trust in God to accomplish His divine purposes through this ministry.

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HHHooowww tttooo AAApppppplllyyy To Apply by Mail:

� Read this information/application packet.

� Complete all forms and send it with your non-

refundable/non-transferable deposit (or full payment) to:

Hands of Compassion International P. O. Box 2004 Appomattox, VA 24522 Attn: Chris Tolley Note: Make Checks payable to Hands of Compassion International PLEASE NOTE THAT DEPOSITS ARE NON-REFUNDABLE AND NON-TRANSFERABLE TO OTHER MISSION TEAM MEMBERS

To Apply Online: � Go to www.handsofcompassionintl.org . Follow the link to

apply and down load information/application packet. Fill out application and mail to the above address.

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FFFrrreeeqqquuueeennntttlllyyy AAAssskkkeeeddd QQQuuueeessstttiiiooonnnsss When should I apply? We recommend applying as early as possible. Registration is open year round. Applications are accepted until mission trip openings are filled, or up to 1 month before schedule departure date. See schedule for application due dates for each trip. How much does it cost? The cost will vary with trip destination & air fare. (see page 5) We require a deposit, which will allow the ministry to purchase plane tickets far enough in advance for best price. Example of cost breakdown for a one week trip to Costa Rica or Guatemala: Room & Board - $400-$500 Plane Tickets - $600-800 Airport Tax - $3.00-$30.00 (varies) (paid by applicant)

• Participants staying more than eight days will be charged and additional $35.00 per day for room and board.

• See additional pricing for other trips on page 5

Is transportation provided? All airline transportation will be provided as well as on the ground while on the mission trip. Transportation to and from the airport will be set-up and provided for by the partnering group or Church. Can I bring my children with me? We encourage families to bring all their family members, but we will discourage any children under the age of 10 years old to participate. All children under the age of 15 shall be accompanied by a parent or legal guardian. The mission trips are usually in rough terrain and great distances from any major emergency medical needs.

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Location 2011-2012 Dates

Approx. Cost

Deposits

/Due Date

2nd Paymt /Due Date

Final

Paymt/ Due

Maximum # of people

Ministry Types

Costa Rica – LCA Sports

Mission Trip

June 13-23, 2011

$1,200 $500/ Mar 3, 2011

$400/ April 7,

2011

$300/ May 5, 2011

35 Soccer Tournament, Cross country, track

Sports Outreach Evangelism,

Guatemala (Xejeyup) WORK

AND WITNESS

July 2-9, 2011

$ 1,200 $500/ February 20, 2011

$400/ April 17,

2011

$300.00/ June 19,

2011

20 Village Ministry

Evangelism, Small Group Discipleship Construction & Children Ministry

Romania August 20-30,2011

$2,400 $800/ May 15,

2011

$800/ July 1, 2011

$800/ August 1,

2011

15 Village Ministry

Evangelism, Construction & Children Ministry

Guatemala (Xejeyup) WORK

AND WITNESS

January 7-14, 2012

$ 1,300 $500/ August 1,

2011

$500/ September 15, 2011

$400.00/ November 15, 2011

20 Village Ministry

Evangelism, Small Group Discipleship Construction & Children Ministry

Haiti (TBD)

January (exact date TBD)

$1,200-$1,500

$500/ September

1, 2011

$400/ October 1,

2011

$300.00/ December 1, 2011

12 Hope for Haiti Disaster Relief

Construction and Church Planting, Training Pastors

Costa Rica LCA Youth

Camp Mission

Trip

March 2012(Spring Break)

$ 1,300 $500/ November

1, 2010

$500/ January 1,

2011

$300/ March 1,

2011

35 Youth-Family Mission Trip

Evangelism, Construction & Children Ministry

Uganda August 2012(exact date TBD)

$2,400 $800/ April 1,

2012

$800/ June 1, 2012

$800/ August 1,

2012

15 Village Ministry

Evangelism, Construction & Children Ministry

STMT General Requirements:

• All applications will be due five (5) months prior to mission trip date. • All applications subject to acceptance by the HOCI short term mission board. • For more information go to the website at www.handsofcompassionintl.org or contact Chris Tolley

at ctolley@handsofcompassionintl.org. • Make all checks payable to Hands of Compassion International, Inc. and mail to Hands of

Compassion, P. O. 2004, Appomattox, VA 24522

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HHHaaannndddsss ooofff CCCooommmpppaaassssssiiiooonnn IIInnnttteeerrrnnnaaatttiiiooonnnaaalll PPP... OOO... BBBoooxxx 222000000444

AAAppppppooommmaaattttttoooxxx,,, VVVAAA 222444555222222 PPPhhhooonnneee (((444333444))) 222444888---555222333666

CCCooonnnfffiiidddeeennntttiiiaaalll SSShhhooorrrttt---TTTeeerrrmmm MMMiiissssssiiiooonnnaaarrryyy AAAppppppllliiicccaaatttiiiooonnn FFFooorrrmmm 111000111222AAA Applying for a trip to: ________________________ G roup/Church: ___________________________________ Name: Dates of Trip: ____________________________________ Mr. Mrs. Miss __________________________________________________________________________________ Last First MI Present Address (street, city, and zip): _____________________________________________________________________________________________ Current Phone Numbers: Home: ( ) ____________________ Work: ( )_______________________ Others: ( ) ___________________ ( ) _____________ E-Mail : ________________________________ Occupation: __________________________________________________ Best time to reach you: ________________________________________ Name and address of person to be notified in case o f an emergency (this person will also be listed as your beneficiary on HOCI’s insurance policy): Name: ______________________________________ Phone: __________________________________ Address: _____________________________________________________________________________ Street number/name City State Zip Relationship: _________________________________________________________________________ Date of Birth: ______-- _______-- ________Adult T-Shirt size: (circle one) S M L XL XXL XXXL Passport Number: _________________________ Issued from: ________________________________ Passport Expiration Date: ____________________________ Please type or print your legal name as it is writt en on your passport:

Note: Please provide 2x photocopies of your passport and attach to this application. If you are in the process of applying for a passport, please attach a current photo of yourself.

For Internal Use ONLY Passport Copies ______ Pastoral Ref. ______ Deposit Paid ______ Ministry Team ______ Other ______

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HHHooommmeee CCChhhuuurrrccchhh IIInnnfffooorrrmmmaaatttiiiooonnn Church Name: ________________________________________________________________________ Address: ____________________________________________________________________________ ____________________________________________________________________________________ City State Zip Telephone#: _______________________________ Pastor’s Name: ____________________________ How long have you attended? _____________

MMMeeedddiiicccaaalll RRReeellleeeaaassseee (For Group Trips through Hands of Compassion International and any/all of its sponsoring organizations.)

Name of Participant __________________________________________________________ First Middle Last

Street Address ______________________________________________________________ City, State & ZIP ____________________________________________________________ Date of Birth ____________________________________ Phone # ____________________ Emergency Contact Person ________________________ Phone #____________________ Name of Insurance Company _______________________ Policy # ___________________ Please list any medical Allergies you have: __________________________________________________________________________

__________________________________________________________________________ Please list any medications being taken: __________________________________________________________________________

__________________________________________________________________________ Please list any medical problems, or other pertinent information: __________________________________________________________________________

__________________________________________________________________________ I understand that, in the event medical treatment is required, every effort will be made to notify the emergency contact person. However, if they cannot be reached, I give my permission to Hands of Compassion International and any/all of its sponsoring organizations or an adult sponsor to secure the services of a licensed physician to provide the care necessary, including, anesthesia, for my well being. Signed _______________________________________________Date ________________________ If applicant is under the age of 18 at the time of travel, a parent or legal guardian’s signature is required above.

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WAIVER OF LIABILITY STATEMENTWAIVER OF LIABILITY STATEMENTWAIVER OF LIABILITY STATEMENTWAIVER OF LIABILITY STATEMENT I, release Hands of Compassion International, and any/all of its sponsoring organizations, together with the adults in charge, from any and all claims resulting from injury or damage that may be sustained by myself/my child while participating in the activities of Hands of Compassion International and any/all of its sponsoring organizations. Name of Participant __________________________________________________________ Activity (Mission Work) _______________________________________________________ Dates of Activity ______________________Through _______________________________ Signed _________________________________________Date _______________________ (If applicant will be under 18 years old at time of travel, a parent or legal guardian’s signature is required.)

� During this trip you may be required to do some phy sical activity such as walking, hiking, etc. on some mountainous trails. Do you feel you will be capable of doing this activ ity? _____ Yes _____ No. Explain: _______________________________________________________________________________ _______________________________________________________________________________

� Do you have any physical condition that may limit y our ability to perform the ministry for which you have applied? _____ Yes ______ No. If so, explain : _______________________________________________________________________________ _______________________________________________________________________________

If you require any medications or other personal items such as contact lens solution, special medicines, etc. you must bring them with you on the mission trip. I understand that the medication I require may not be available in the country deployed to. Your initials here _________.

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Have you ever participated in a mission trip outsid e of the United States before? ___Yes ___No. If so, when & where? __________________________________________________________________________________________________________________________________________________________________________ Please indicate which of the following ministries you have enjoyed doing or which may interest you: ____ Evangelism Ministry Experience: ___________________________________________________________________________ ____ Medical Care Ministry Experience: ___________________________________________________________________________ ____ Dental Care Ministry Experience: ___________________________________________________________________________ ____ Children’s Care Ministry Experience: ___________________________________________________________________________ ____ Construction Ministry Experience: ___________________________________________________________________________ ____ Vacation Bible School (VBS) Ministry Experience: ___________________________________________________________________________ ____ Clown Ministry Experience: ___________________________________________________________________________ Special Skills (check all that apply) ____ Administrative ____ Engineering ____ Art Work ____ Electrical/ Wiring ____ Athletic/Sports ____ Journalism ____ Computer (specify) _______________ ____ Carpentry ____ Medical (specify) _________________ ____ Plumbing ____ Dental (specify) __________________ ____ Photography ____ Musical (specify) _________________ ____ Other (specify) __________________________________________________________________________________

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What languages do you speak other than English? _________________________________________ What are the gifts the Lord has blessed you with? ( Explain) _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Are you afraid to fly in an airplane? __________ N ot at all ________ A little _______Yes Do you understand that even though this will be one on of the most memorable experiences of your life, that it is NOT a vacation? _______ Yes _______ No.

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Note: A deposit is required for advance airfare pur chase. This is for the purpose of saving on the cost of the trip. Therefore, the deposit is non-re fundable. Please return your deposit to your respective church mission trip coordinator. Attention: Due to the volatility in the airline ticket prices, fuel costs and other unforeseen factors, the above pricing is subject to change. The required deposit shall be determined by the cost of the trip. The rate is as follows (unless otherwise indicated:

• 30% due at application approval • 60% due 3 months from departure date • Paid in full 1 month from departure date

I have answered the above information to the best of my knowledge with truth and a clear conscience. I am aware that if accepted, I am responsible to raise whatever financial support is necessary to fund this short term mission trip. I further agree to allow Hands of Compassion International to use my picture in ministry publications for the sole purpose of communicating the work that God is doing among the people I am applying to minister to. Signature: ______________________________________________________ Date: ________________ (If applicant will be under 18 years old at time of travel, a parent or legal guardian’s signature is required.) Full Name (Please Print): _______________________________________________________________

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If this is your first mission trip with Hands of Compassion International, please provide a short

personal written testimony below giving us specific information about your relationship with the

Lord and your calling to go on this mission trip.

For pastoral references only: Are you comfortable sending this individual out as a representative of your church? Use additional paper if necessary. _____________________________________________________________________________________ _____________________________________________________________________________________ Pastoral Signature: _______________________________________ Date: _________________________ Name (Print): ____________________________________________ Position/Title: __________________ Address: _____________________________________________________________________________ Phone: ( ) _________________________ Work Phone: ( ) _________________________________ Organization or church to which you belong: _________________________________________________

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I release Hands of Compassion International, or any/all sponsoring organizations from all actions, damages, or personal injuries which may occur. I understand in the event of a minor injury I may receive first aid treatment. If my personal judgment is hindered due to an emergency, injury, or illness I authorize the mission trip leaders to take whatever action is necessary for my personal safety and health. I give my consent that photographs, interviews, and audio/video recordings during the course of the mission trip may be used by Hands of Compassion International for training, promotion, and fundraising. I authorize Hands of Compassion International to contact all references listed herein to verify all information provided and to obtain any and all information related to my character. I release all references from any liability for information provided in good faith. Signature: ______________________________________________________ Date: ________________ (If applicant will be under 18 years old at time of travel, a parent or legal guardian’s signature is required.) Full Name (Please Print): _______________________________________________________________