Short Term Missions Interest Form

Your name *

Last name

Email address *

Phone number *

Phone type

Gender *

Birthdate *

Which trip(s) are you interested in? *

Kenya (11/7/2025 - 11/15/2025)

Cambodia (2/13/2026 - 2/22/2026)

Slovenia (2/14/2026 - 2/21/2026)

Southeast Asia (3/5/2026 - 3/14/2026)

Washington DC (4/10/2025 - 4/15/2025)

Costa Rica (4/25/2026 - 5/1/2026)

Kenya (5/15/2026 - 5/23/2026)

France (6/6/2026 - 6/13/2026)

Cuba (7/11/2026 - 7/17/2026)

Rwanda (7/16/2026 - 7/25/2026)

Brazil (8/1/2026 - 8/8/2026)

Panama (8/28/2026 - 9/6/2026)

Washington DC (9/18/2026 - 9/23/2026)

Guatemala (Medical) (9/19/2026 - 9/26/2026)

North Africa (10/3/2026 - 10/10/2026)

Colombia (10/10/2026 - 10/16/2026)

Southwest Asia (10/15/2026 - 10/24/2026)

Kenya (11/6/2026 - 11/14/2026)

Medical Missions (Dates and Locations vary)

Do you attend Two Cities Church? *

Do you have a valid passport? *

In a few sentences, what is the Gospel? *

In a few sentences, tell us about how you became a follower of Jesus. *

In a few sentences, why are you interested in going on a short-term mission trip? *

Do you have previous missions experience? If yes, briefly share about your experience(s). *

In a few sentences, how are you currently serving in the church? *

Please list any specific skills, talents, or experiences that you can use to serve in a particular area (ie. medical, second languages, construction, etc.) *

Do you have any allergies or dietary restrictions? *

Are you currently taking any medications that the trip leader should be aware of? If yes, please list below. *

Do you have any health concerns that might hinder you during a mission trip? *

How do you plan on covering the cost of the trip? (We offer resources and coaching in the support-raising process) *

I affirm the Baptist Faith & Message 2000 *

https://bfm.sbc.net/bfm2000/

Is there anything else you would like to add? Do you have any questions you would like to further discuss? *

The next step in the process will be a 30 minute phone call with our missions staff. Please list your availability over the next two weeks, and someone from our staff will confirm the date and time via email. *

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Two Cities Church
contact@twocitieschurch.net
336-793-4360

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