Get Involved> For Individuals> Short-term Missions> Join a Team!> Bangladesh 2011 Application

Bangladesh Team Application

We are thankful for your desire to serve alongside Food for the Hungry in our mission to walk with churches, leaders and families in overcoming all forms of human poverty. You’ll be going to a developing country for one to two weeks out of the year. Our hope is that this experience will ignite your passion and fuel your fire to take action the other 50 weeks of the year. The purpose of a team experience is to relationally engage with the poor on a deeper level. As you travel on this journey, we pray that you become part of God’s story for this community. And when you return home, would consider how to spur others on toward love and good deeds by advocating for the community through child sponsorship. We hope that you come away from this experience equipped and engaged in your lifelong advocacy for the poor worldwide!

Instructions: Before beginning this application, please look through the application in its entirety to make sure you have all of the requested information with you. The application must be completed in one sitting. Previously entered information will not be available for your retrieval at a later date. After completing the application and hitting the "send" button, please be sure to look for the verifcation page to be sure your application has been submitted successfully.

First Name

Middle Name

Last Name

Nickname

Gender

Date of Birth

Marital Status

T-shirt Size

Permanent Contact Information

Address


City


State


Zip


Phone Number


Email Address


Current Contact Infomation (If Different Than Above)

Address


City


State


Zip


Phone Number


Current Until (List Date)

Church Information

Church Name


Denomination


City


State


Reference (Pastor, Mentor or Bible Study Leader)

Name


Phone Number


How Long Have you Known Them?


Email Address


Relationship to You?


Reference (Personal)

Name


Phone Number


How Long Have you Known Them?


Email Address


Relationship to You?

Reference (Professional)

Name


Phone Number


How Long Have you Known Them?


Email Address


Relationship to You?


Education

School


Level of Education


Field of Study


Year of Graduation


Experience

Employer


Occupation


List Your Work Skills


Travel Information

Passport Number (if you are in the process of applying for a passport, simply enter "IN PROCESS")


If you already have a passport, please complete the following:

Country of Issuance


Date of Issuance


Date of Expiration


Place of Birth

Child Sponsorship

Child sponsorship is the single best way to contribute to the progress of overcoming poverty in the community you will visit. Through the relationship with one child, and the impact your financial contribution makes to equip families to care for their children, you can bring lasting change to a developing community.

If you are interested in sponsoring a child, please check here:
Yes

If you already sponsor one or more children, please list the name and ID number of any children you sponsor in the community where your team will serve. Multiple names and ID#s should be separated by a comma.

Child's Name


ID Number


Brief Essay Questions

Have you traveled internationally or served on a mission trip before?
Yes
No


How many FH Short-term teams have you served on?


If you have previous international travel experience, please complete the information below for your three most recent trips by listing the place you traveled, the length of the trip, and the reason for your travels (personal, business, mission trip with another organization, mission trip with FH).

Where


Length of trip


Reason for trip

Trip #2 (if applicable)
Where


Length of trip


Reason for trip

Trip #3 (if applicable)
Where


Length of trip


Reason for trip


Why do you want to serve on this short-term mission team?


Do you attend church regularly?


If so, please list in what capacities you serve (children's ministry, leading a small group, etc)?


Briefly describe how you came to faith in Christ as well as any past or present experiences you consider major events in your walk with Christ.

Emergency Contact

IN CASE OF EMERGENCY CONTACT:

Name


Area Code & Telephone #

Alternate Area Code & Telephone #

E-mail

Relationship to You

Secondary Emergency Contact

Name


Area Code & Telephone #

Alternate Area Code & Telephone #

E-mail

Relationship to You


Medical Information

Please complete this section to the best of your ability. If certain information is unknown, simply enter "unknown". If a required field is not applicable to you, simply enter "none".

Insurance Company


Policy #


Date of last Polio and MMR shot


Blood Type


Date of last Tetanus shot


Have you ever suffered a serious illness, had surgery performed or been hospitalized?
Yes
No

If yes, please explain


List any known dietary restrictions or food allergies


List any other known allergies


List anything for which you are currently receiving medical treatment or for which you are under medical observation


List any prescription medications you take regularly


Are you currently or have you ever been treated for mental health issues
Yes
No

If yes, please explain


Please explain any other limitations or significant health conditions which might affect your involvement with Food for the Hungry or which you believe your physician would want us to know about


Team Participant Profile
Other than English, list any languages you speak which might be relevant in the community in which you will be serving. Please list your level of proficiency in each.


Place a check next to any of the skills you have which may be helpful while serving with your team.
Construction
Computer Skills
Writing, story telling, and blogging
Bible Preaching/Teaching
Children’s Ministry/VBS
CPR/First Aid
Drama
Evangelism
Medical (Professional)
Play an instrument.(Please list below)
Singing
Sports Ministry
Teaching (Professional)
Teaching English as a second language
Youth ministry
Other (Please list below)

Additional Information:

Our Statement of Faith

We Believe:

  • The Bible to be inspired, the only infallible, authoritative Word of God.
  • That there is one God, eternally existent in three persons: Father, Son, and Holy Spirit.
  • In the deity of our Lord Jesus Christ, in His virgin birth, in His sinless life, in His miracles, in His vicarious and atoning death through His shed blood, in His bodily resurrection, in His ascension to the right hand of the Father, and in His personal return in power and glory.
  • That for the salvation of lost and sinful people, regeneration by the Holy Spirit is absolutely essential.
  • In the present ministry of the Holy Spirit by whose indwelling the Christian is enabled to live a godly life.
  • In the resurrection of both the saved and the lost; they that are saved unto the resurrection of life and they that are lost unto the resurrection of damnation.
  • In the spiritual unity of believers.

I have read and agree with Food for the Hungry’s Statement of Faith
Yes
No

Participant’s Agreement
Place a check mark in the box next to each statement indicating that you have read and agree with the statement.
I promise to complete the pre-field training material before my team experience.

I will strive to have a servant’s attitude at all times and will avoid complaining during my trip.

I will obey the leadership on my team.

I will not use bad language, alcohol, drugs or tobacco during the trip.

I will follow all safety precautions during the trip.

I will remember that I have come to learn, not to teach. I may run across procedures that I feel are inefficient or attitudes that I find closed-minded. I will be open to learning other people’s methods and ideas.

I will be considerate of my relationships with fellow team members, Food for the Hungry staff and community members. I will remember not to be exclusive in my relationships and will strive to interact with all in a way that honors Christ and is an example of biblical community to others.

I realize that our team is in-country for just a short while, but that Food for the Hungry will maintain work in the community. I will respect the knowledge, insights, and instructions of those our team will be working with.

I understand that one of the goals of my trip is to share God's heart for the poor with others when I return.


Confidential
This form is to be completed by anyone desiring to serve on a short-term team that involves supervision of or interaction with children. This is a confidential form used by Food for the Hungry in order to provide a safe and secure environment for those who are ministered to, cared for or participate in activities lead by or in conjunction with Food for the Hungry.

Do you have any physical or mental conditions that would prevent you from performing activities related to working with children?


Have allegations ever been made against you for committing a crime against a child?


Have you ever been convicted of or plead guilty to child abuse or a crime involving actual or attempted sexual molestation of a minor?

Have you ever tested positive for an infectious disease?


If you answered “Yes” to any of the questions above, please explain


I certify that all answers given are true and complete to the best of my knowledge.
Yes

DISCLOSURE OF RISK: AGREEEMENT OF WAIVER, RELEASE, & HOLD HARMLESS

There is inherent risk associated with any type of international travel. Food for the Hungry recommends that you utilize the U.S. State Department’s website (http://travel.state.gov) to keep informed of situations in the country in which you intend to serve. By submitting this agreement, you acknowledge that you have been made aware of this informational resource.

1. I understand that any travel, volunteer work, or other activities I undertake in connection with Food for the Hungry, Inc., the Food for the Hungry Association, partnering agencies, organizations, or individuals (hereafter, collectively referred to as Food for the Hungry) involves inherent risk on my property, health, and life and I further understand the nature of such risks.

2. I have been and am informed by this document that any travel, volunteer work, or other activities I undertake in connection with Food for the Hungry presents inherent risk, including, but not limited to, loss of property, disease, illness, injury, exposure, physical and mental harm, and death, which may be caused by, among other things, the elements, organisms, environmental conditions, crime, accidents, negligence, and political conflict including civil war, war, and terrorism.

3. No principle, officer, agent, employee, or other person associated with or acting on behalf of Food for the Hungry has disavowed or contradicted anything in this document, including the statements, regarding the existence and nature of the risks involved.

4. The undersigned recognizes and acknowledges that Food for the Hungry, Inc and the Food for the Hungry Association are charitable, non-profit corporations engaged in human services and relief activities. The undersigned, for himself/herself and his/her heirs, does hereby freely and knowingly waive any and all actions, causes of actions, claims, and demands for or by reason of loss of life, bodily injury loss, including, but not limited to the contraction of any endemic diseases, costs, damage, or expense for any act or omission on the part of a third party or on the part of Food for the Hungry or any of its officers, agents, servants or employees for anything in any way arising from or connected with, either directly or indirectly, any volunteer activities of the undersigned Volunteer or of Food for the Hungry. The undersigned realizes that activities which he/she intends to pursue may entail some amount of risk or possible danger and desires to personally assume such risks.

5. This agreement is intended to be as broad and inclusive as permitted by the laws of the State of Arizona. This agreement is to be governed by the laws of the State of Arizona. If any portion of this agreement is held invalid, it is agreed that the remainder shall nevertheless continue in full force and effect.

6. I enter into this agreement freely and voluntarily in consideration of the permission to participate in the Activities described herein and of the benefits associated with such activities. I understand that this agreement is contractual and binding upon me.

7. In an emergency, I give my permission to a licensed physician to hospitalize, anesthetize, or perform surgery as needed. I understand that every reasonable effort will be made to contact my family before these actions are taken.

I have read this document and understood and agreed to all of its contents before signing it. I have also had every opportunity necessary to ask questions concerning the risks and hazards I am assuming in each of the countries I will visit or work in. I also have had adequate time to review, analyze and think of this document’s contents, before signing the document.

I certify the above information is correct and I HAVE READ THE DISCLOSURE OF RISK: AGREEMENT OF WAIVER, RELEASE AND HOLD HARMLESS.


Yes

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