Name
*
First Name
Last Name
birthday
*
MM
DD
YYYY
Email
*
What Area of Team Xtreme International are you signing up for?
*
Full Time Staff
Kingdom Leader Internship
Proclamation Coalition Internship
TX Startup Internship
Xtreme Love
Preferred starting date
desired length of commitment ( if joining staff )
passport # (if available)
Date and place of issue
Name as it appears on your passport
Current Mailing address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Phone number
*
(###)
###
####
citizenship
*
marital status
*
current home church
name of pastor
*
First Name
Last Name
home address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
work number
(###)
###
####
cell number
*
(###)
###
####
health insurance company
policy #
physician's name
First Name
Last Name
Physician's phone #
(###)
###
####
do you have any medical restrictions or handicaps that we need to make provision for?
*
if yes, please explain
are you presently taking and medications?
*
do you have any dietary restrictions?
*
Have you completed a Discipleship training school with youth with a mission?
*
Where did you do your DTS?
Name of school leader
First Name
Last Name
active email address for school leader
Active phone number for school leader
(###)
###
####
primary areas that you would like to serve in. (select 1-3)
*
If other, please explain
Why did you choose above areas?
*
please briefly describe your family, including placement in the order of your siblings
*
what is your primary reason for wanting to serve on team xtreme international?
*
Have you served in any cross-cultural settings as a missionary and/or volunteer before? If so, please list organization, date, & purpose
*
What ministry experiences have you led or participated in at home?
*
How do you use your free time?
*
What do you hope to learn or gain from this experience?
*
Are there any realistic roadblocks that might hinder you from coming?
*
What does the word “flexibility” mean to you?
*
Describe your personal devotional/quiet time. How does it influence your life?
*
Describe your relationship with Jesus Christ and how you became a Christian.
*
What do you see as some of your strengths and weaknesses?
*
Share of an experience when you found yourself heavily reliant upon God to get you through a certain situation.
*
Please provide a list of references including name, address, phone number, and email address. Please have them email us their referral at info@teamxtremeintl.com · One Christian leader from your church (can be Pastor, Sunday School Teacher, Bible Study Leader, etc.) · Two others who know you well. We would suggest a teacher, boss, coworker, fellow-student, or friend.
*
I herby certify that all information has been filled out truthfully and to the best of my knowledge
*
First Name
Last Name
