Application for Individuals
 and Couples and Families
Mission Builders International
 P.O.  Box 406   Lakeside,  MT  59922   USA
mbi@missionbuilders.net

 Application Date   ( Please enter today's   date - mm/dd/yyyy )

PERSONAL INFORMATION
Self
Title
First Name
Middle
Last Name
Suffix
Nickname if different than first
   
Gender
Birth Date a complete date please
Height
Weight
Blood Type (optional)
   
Occupation:
Spouse
Title
First Name
Middle
Last Name if different
Suffix
Nickname if different than first
   
Gender
Birth Date a complete date please
Height
Weight
Blood Type  (optional)
   
Occupation:
Marital Status       Anniversary Date    enter a complete date please (mm/dd/yyyy)
Denomination    ( Optional )

Contact Addresses
Primary   street address
    second line - usually blank
City   State    ZIP/Post-Code 
Country   (if not USA)  
   
Second   street address
    second line - usually blank
City   State    ZIP/Post-Code 
Country   (if not USA)
   
Third    street address
    second line - usually blank
City   State     ZIP/Post-Code 
Country   (if not USA)    Please indicate seasonal time periods in the Address Notes.
   
Address Notes:
Contact Preference    ( Select the manner or method by which you prefer for MBI to contact you. )
 
Phones, Email-Addresses, Web-Site-URLs
Phone Notes: 
 
Self  --  Languages
Proficiency = Native
Spouse  --  Languages
Proficiency = Native
Language Notes: 
 
List Children and other Dependents who will accompany you:
    Name     Birth Date       Gender       Relationship
    Name     Birth Date       Gender       Relationship
    Name     Birth Date       Gender       Relationship
    Name     Birth Date       Gender       Relationship
    Name     Birth Date       Gender       Relationship
    Name     Birth Date       Gender       Relationship
Dependent Notes: 

 

VOLUNTEERING INFORMATION

Geographical Areas of Interest
All Regions Asia Europe  North America
  South America Australia / Oceania Africa
 
   Notes: 
 
Countries of Interest
 
   Notes: 

Specific Field Ministry Project(s) of Interest (as listed on the web site)
 

Which months can you generally go on a Mission Builders project?
January February March April
May June July August
September October November December
How long are you generally available each year? (eg  2, 3, ... , 12 weeks)
 
Specific Dates you are Available
Starting Date Ending Date Number of Weeks available during that time;  Comment
        Use These Dates as approximate dates the next year.
 
  Notes: 
 
SKILLS   -- Your Abilities offered in His service

Please enter "Skill Level" numbers for yourself   (and for your spouse if applicable).

Skill Levels 
  Blank - No Skill, Aptitude or Interest
  1 - Need Supervision  / Guidance
  2 - Able to Work Independently 
  3 - Able to Teach and Lead Others
Skill Self Spouse   Skill Self Spouse
Accounting   Administrator, Plan / Dev.
Agriculture   Architect
Auto Mechanic   Bible Teaching
Business   Clerical / Office Work
Carpenter   Computer Technician
Child Care   Concrete - Slabs
Cooking   Dental Hygienist
Counsel/Discpl.   Dentist
Database Mgmt   Doctor (MD)
Drywall / Sheetrock   English Second Lang.
Electrician   Evangelism
Engineer - Civil/Mech.   Framing Carpenter
General Labor   Heavy Equip Operator
Graphic Design   Housekeeping
Heat/AC   Hospitality
Human Resources   Landscaper
Insulator   Serving Team Leader
Interior Design/Decor   Legal Services
Manager, Fac Project   Nurse
Marketing & Comm.   Painter
Mason   Pastoral Care
Planner, Master   Rebar Worker
Plumber   Resource Dev. (Fincl.)
Prayer / Intercession   Roofing - Metal
Sewing   Concrete - Structural
Site Development   Surveyor
Steel Framing   Teacher / Arts & Crafts
Web Design   Roofing - Shingle
Welder   Roofing - Tile
 
  Notes: 

 

REFERENCE INFORMATION

Home Church 
Denomination
Pastor - Title
First Name Nick Name  if different than first
Middle Name
Last Name
Suffix Gender 
Address  
  street address
    second line - usually blank

City

  State    ZIP/Post-Code 

Country   

  (if not USA)
   
  Phones, Email-Addresses, Web-Site-URLs
     
 Notes:  

 

EMERGENCY CONTACT INFORMATION

Contact - Title
First Name Nick Name  if different than first
Middle Name
Last Name
Suffix Gender 
Address  
  street address
    second line - usually blank
City   State     ZIP/Post-Code  
Country      (if not USA)
   
  Phones   and   Email-Addresses


  Notes: 

 

EXPECTATIONS and BACKGROUND

  How did you first hear of Mission Builders International?    
 

  What reasons most influenced your decision to apply?
 

  What expectations do you have as a Mission Builder?
 

  Prior Mission Builders experience ( what / when / where ) ?
 

  Other missions experience ( what / when / where ) ?
 

Are you interested in being an MBI project team leader?   Yes
   (Leadership Training is provided by Mission Builders staff.)

 

STATEMENT OF FAITH

Trusting in Jesus Christ as my Savior, I believe in:
            -The Bible as the inspired Word of God;
            -The Deity of our Lord, Jesus Christ, God’s son;
            -The vicarious death of Jesus Christ for our sins, His bodily resurrection and His personal return;
            -The presence and power of the Holy Spirit in the work of regeneration.

    I/We have read the Vision, Mission, Values Statements and the Statement of Faith.  I/We believe and accept them in being considered for service.  If accepted,  I/We will abide by the spirit and guidelines of Mission Builders International and the applicable project.

  Signature: (By filling in your name, you in essence sign, indicating your agreement.)
 
   Date:

  Spouse’s Signature:
 
   Date:

 

RELEASE FROM LIABILITY

    I/We hereby agree to hold harmless, and release from any liability, Mission Builders International and applicable project, its agents, employees and volunteer assistants, from any liability whatsoever arising out of any injury, damage or loss which may be sustained during my/our time of involvement with Mission Builders International. I/we state that I/we knowingly waive any and all rights to initiate any action before any court of law or equity against Mission Builders International relating to my/our voluntary choice to be involved with Mission Builders International.

  Applicant’s Signature:
    Date:

  Spouse’s Signature:
   Date:

  If applicant is under 18 years of age, signature of parent or responsible party is also required.

  Signature:
    Date:

 (By filling in your name, you in essence sign, indicating your agreement.)

Please print out the  Statement of Faith  and  Release From Liability sections to sign, date and mail to the Mission Builders address above.

THANK YOU for taking the time to fill in all the above information -- it helps us serve you.