Savings Already Totals $30K
Mission Centre is Going UP!
MK Returning to Jamaica!
Team One Expanding!
Gerry Dangerfield's Work In Jamaica
I Hear It Often
Jamaica Journey 2009
Rev. Lionel Brown, DS Jamaica West District
History of Jamaica
Father of Work & Witness Retires
Raising Money for Your Work & Witness Advenure
Talents + Life Experiences + PrimeTimers = Valuable Service
Can I Get A Refund If...?

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Contact Information

If you would like to apply for Jamaica Journey 2009, please fill out our online application below. Or You may wish to print up our PDF version: Application (requires Adobe Acrobat Reader) and mail it to us.

(We understand that some of the information requested on this application is sensitive. So to best protect your information, we have created a two-part application for the online process. After you fill out and submit the first part of the application below, you will be directed to a downloadable PDF form as the second part. Please print, fill out, and mail it in with your initial check.)

Personal Information

Title: Name (Full Name):
Address 1:
Address 2:
City:
State:
Zip:
Country:
Telephone:
E-mail:
Home Church:
Church District:
Birthdate (mm/dd/yyyy):
Your Relationship with Christ?
Church Attendance?
Church Membership?
Shirt Size:

Trip Information

How many Work & Witness Trips have you taken?
If so, where?


Life Skills

Please check as many as the life skills below that apply to your life:
Loving People
Hugging People
Encouraging/Comforting Others
Learning/Teaching New Skills
Praying
Smiling
Shaking Hands
Good Attitude
Construction
      Specify Skills:
Maintenance
      Specify Skills:
Outreach/Evangelism
Discipleship/Follow-up
VBS
Visitation
Jail Ministry
Bible Study
Medical
      Specify Specialty, License, and/or Certification:
Dental
      Specify Specialty, License, and/or Certification:
Optical
      Specify Specialty, License, and/or Certification:

Emergency Contacts

Primary Contact's Name:
Relationship:
Home Phone:
Work Phone:
Cell Phone:
Pager:
E-mail Address:

Secondary Contact's Name:
Relationship:
Home Phone:
Work Phone:
Cell Phone:
Pager:
Email Address:

Pastor's Name:
Home Phone:
Work Phone:
Cell Phone:
Pager:
Email Address:

Doctor's Name:
Home Phone:
Work Phone:
Cell Phone:
Pager:
Email Address: