Volunteer In Mission Application Please complete the form below to apply. Name* First Last Email* Phone*Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home Church*Have you participated in a Volunteer in Mission (VIM) trip before?*Select OneYesNoWhen?* MM slash DD slash YYYY List the start date of your most recent trip.Where?*Where did you go on your last VIM trip?Do you have any medical concerns that would need to be considered if you participated in a VIM trip?Select OneYesNoPlease specify:*What interest fo you have in this VIM trip? What do you hope to accomplish?*What skills do you have? Rank from 1 to 5: (1) being "I have no experience at all"(3) being "I have some experience and would be willing to accept the work I do in my own or a family member's home"(5) being "licensed and experienced in this work"Building and Renovation SkillsCarpentry*Select One12345Plumbing*Select One12345Electrical*Select One12345Wallboard/Plaster*Select One12345Block or Brick Masonry*Select One12345Painting*Select One12345Yard work, Landscaping*Select One12345Demolition*Select One12345Tile work, Flooring*Select One12345Roofing*Select One12345Siding*Select One12345Window/Door Installation*Select One12345Other skills or interests:Planning Travel for a groupSmiling and encouraging othersCooking for a groupLeading devotions or worshipDriver (van, truck, or other vehicles)ctrl+click to select more than one optionT-shirt Size?*Select OneExtra SmallSmallMediumLargeExtra LargeXX LargeXXX LargeEmergency ContactEmergency Contact Name:* First Last Emergency Contact Email Emergency Contact Phone* Δ