EXITE Application

Date*
MM slash DD slash YYYY
Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email
Date of birth*
Year of High School Graduation*
- 2021
- 2022
- 2023
- 2024
What foreign languages have you studied? How would you describe your fluency?
Do you have any health conditions we should know about?*
Do you have any allergies? If so, what are they?*
Are you on any medications? If so, what are they?*
Please share with us your testimony of how you became a Christian.
Church you attend regularly*
What church activities have you been involved in since becoming a Christian?*
What has led you to consider becoming a member of an EXITE team?*
Are you willing to commit to investing consistent time and energy in spiritual preparation for this trip under the direction of your pastor?*
- Yes
- No
What hobbies and leisure activities do you enjoy?*
Have you ever traveled overseas? If so, where?
Are you employed? If so, where?*
Have you ever participated in, been accused or convicted of, or pled guilty or no contest to any abuse or sexual misconduct?*
- Yes
- No
If yes, please explain.
Are your parents in agreement with you going overseas?*
- Yes
- No
Do you have a relationship with someone else applying to go on this trip? if yes, who?*
Please give names and complete addresses and emails of three people not related to you whom we can contact for references. One must be your current pastor. They will be asked to respond concerning your skills, limitations, professional judgment, ethics, or any concerns with your work.*
Name Address Email Phone #
Name*
First Last
Please submit this completed application by February 21, 2021. Also send the application fee of $100 (refundable until April 18, 2021) in the form of a personal check or money order made payable to Grace Ministries International, PO Box 9405, Grand Rapids, MI 49509. Upon acceptance into the EXITE program, the fee will be applied to the cost of the trip. If you are not accepted, the $100 fee will be promptly reimbursed.
Date
MM slash DD slash YYYY
Email
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