POLAND 2026 - Short Term Missions Application

PERSONAL INFORMATION

Name

Gender

Male Female

This address will receive a confirmation email

Phone

Address

Birthdate

Citizenship

Passport #

Passport Expiry

I currently

Am a full-time student Am a part-time student I work full-time I work part-time I am looking for work Other

Please explain your answer to the question above (what is your job, or where do you go to school, etc)

I am willing to obtain a police check

Yes No No, Cedar Creek has a current police check for me on file No, I am under 16 and do not require one

EMERGENCY INFORMATION

Health Card #

In case of emergency please contact

Relationship

Phone

Do you have out of province travel insurance?

Yes No, but I understand that I will need to purchase it

If yes, please list the company name, group and policy number.

Does your insurance company require that they are contaced before you receive treatment?

Yes No

HEALTH INFORMATION

Do you have any allergies? If so please list and explain the signs and symptoms when you are having a reaction. Also list any prescriptive/preventative measures that you take.

Do you have any food allergies or dietary restrictions?

Are you on any medications? If so please list the medications and briefly explain what they are for.

Do you have any past or current health concerns that may impact your participation in this missions experience?

SPIRITUAL JOURNEY

How did you become a Christ follower and what has God been doing in your life lately? If you are not a Christ follower, where are you at in your spiritual journey?

How long have you been attending Cedar Creek? If you do not attend Cedar Creek, please identify your home church.

What ministries are you currently involved with?

MISSIONS

Why do you want to participate on the POLAND Missions team?

What do you hope to get out of this experience? What do you hope to contribute?

Have you participated in a missions experience before? If yes, where? What is one thing that learned?

What is the most important characteristic that you think each team member should possess?

What is one strength you will bring to this team? What is one weakness we should be aware of?

Do you have any specific certifications, skill sets, or giftings that may be an asset to this team?

Is there anything else that we should know?

REFERENCES

Reference 1 - Name

Reference 1 - Relationship to applicant

Reference 1 - Phone

Reference 1 - Email

Reference 2 - Name

Reference 2 - Relationship to Applicant

Reference 2 - Phone

Reference 2 - Email

MISSIONS COMMITMENT

If accepted, I commit to:
- Serve as a follower of Christ as obediently, faithfully and excellently as I can
- Participate in pre-project team meetings, fundraisers, trainings, and events
- Participate in post project debriefs and celebrations
- Be in regular prayer for POLAND team members and people we will serve
- Submit to the team leaders and the host organization's authority
- refrain from any behaviour that may compromise my witness (vulgar language, drugs, sexual references, drug use, immodest dress, etc.)
- Obtain any immunizations, documentation, or insurance that I may require to travel to Poland
- Accept a posture of humility and service
- If my behaviour should ever negatively impact the team or the students we are serving I recognize that the team leader has the authority to send me home at any time. Any additional costs incurred as result of this will be my responsibility.

I agree to the above

Yes No

Submitted by

Witness name (if under 18)

POLAND 2026 - Short Term Missions Application

Description

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