Please complete all fields below.
Describe how you would work in a situation that may include: communication boundaries, limited food options, and perhaps shared sleeping quarters:
Have you ever been convicted of a felony? If yes, explain.
The general per-person cost of the trip is approximately $3,000-$4,000. If selected what portion of the trip would you have the ability to self-fund or raise?
Have you traveled internationally? YesNo
If "yes" describe fully:
…to which countries?
…in what capacity?
…your best experiences
…your worst experiences
Do you have any experience with international students or clients? Explain:
When did you become a Christian?
Please describe your personal walk with the Lord at this time:
Please share some of your personal ministerial strengths as they would relate to this trip:
Please share some of your personal ministerial weaknesses as they would relate to this trip:
Do you have any limitations related to walking or mobility? YesNo
Do you have any medical conditions for which you are currently receiving treatment? YesNo
Do you have any physical limitations or disabilities? YesNo
Are you presently being treated for any mental or emotional conditions? YesNo
Are you currently taking any medications? YesNo
Personal and Professional References
Please list 2 references. It is your responsibility to provide your 2 references with a printed EEM reference form from this site or with instructions for accessing the online reference form from this site. EEM will not contact these names about receiving your references. Each reference needs to be an unrelated/non- family member who has known you for at least 3 years. One reference needs to be filled out by a church minister or church leader and the 2nd by an employer, co-worker or professor.
Hold Harmless Agreements
I AGREE TO RELEASE, HOLD HARMLESS AND INDEMNIFY FROM ANY AND ALL CLAIMS ASSERTED BECAUSE OF ANY INJURY TO MYSELF, Eastern European Mission | Character International, all of its affiliates, and all individuals, named and otherwise, participating with the explicit approval of the duly authorized representative of Eastern European Mission and Character International, including but not limited to volunteers, from any and all damages arising during the period of my participation in the EEM | Character International Program as I travel to Ukraine and return to the United States. I do hereby agree to hold Eastern European Mission | Character International harmless and agree to indemnify fully Eastern European Mission and Character International for any and all judgments and damages rendered against it and including costs, attorney's fees, regardless of whether or not there is litigation and including mediation and arbitration proceedings which result from or that are in any way connected with monetary, physical, mental, emotional or other type claim of injury to me that is claimed or asserted.
I have read and agree to the above terms.