Click to edit this text...
Click to edit this text...
Jordan International Aid : Application
Updated Jan 15, 2010: Thank you for taking an interest & deciding to apply to Jordan International Aid! The opportunity to travel and help people in need is extremely rewarding. This organization gives many the chance to be apart of a project that is truly in ACTION. As you might have seen from the JIA site, we are on the move and need team members to go with us. Upon completion one of the coordinators eXport eXtreme new membership group will reach out to you via email to confirm we have received your application. Here is the most recent info. We were planing on going to Nicaragua in March-April,but do to recent emergency need to Haiti will will be focusing our efforts for Haiti. You can visit us on Facebook at : http://apps.facebook.com/causes/305383 or our website at http://www.jordaninternationalaid.org .Our facebook site contains images and videos of our humanitarian effort. Jordan International Aid has been confirmed on Facebook as a registered Non-Profit organization and has allowed a donation link on a site. As we are planning a project to Haiti, please suport this effort. All proceeds are going to Haiti and the medical partners who are assisting us in the post-relief effort.Facebook uses a secure third-party organization called Network for Good, which processes donations made through Causes and distributes them to your chosen charity. Visit our site and donate on Facebook - http://apps.facebook.com/causes/305383 This is your call to action! Come with us and make a difference in the lives of children and families in need. We need volunteers to assist in this project to bring medical relief, provide food distribution, equipping the community, bringing toys and supplies to the children of developing areas in Haiti. Many have been asking for this trip and now is your chance to be a part of a worldwide project.
If you select "Subscribe to updates" in the application below, we will include you on any updates to future trips. Please complete the application entirely. (Allow 15 minutes to complete). There is no ability to save and return to the application. Please complete to the best of your ability.
...
Click to edit this text...
Destination of Interest (if known)
General Information
First Name:
*
Last Name
*
E-mail:
*
Home Phone:
*
Cell Phone
Age
Preferred Method of Contact
*
Email
Text
Cell
Home Phone
Citizen of what Country
Gender
*
Female
Male
I have a valid passport
Yes
No
Date of Birth
-
Month
-
Day
Year
at
/
Hour
Minutes
AM
PM
Date of Birth (MM/YY)
Marital Status
Single
Married
Divorced
Address:
Click to edit this text...
Click to edit this text...
Click to edit this text...
City:
State:
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
District of Columbia
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
District of Columbia
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Zip code:
Click to edit this text...
SELECT JIA PROGRAM
Xport Xtreme
This program is designed to launchworldwide missionary efforts for youth. Joining this program meanshaving the opportunity to travel to foreign countries and providedirect aid. Of course this will mean a stronger commitment andinvestment, but one that will reap huge rewards.
serveNET
This program is designed for those who can volunteer time and resources locally. For example: packaging supplies, recruiting sponsors, assisting in fundraisers.
Plan-IT
PlanIT (planet) is a program designed to launch worldwide campaigns and efforts. Joining this program means having the opportunity to travel to foreign countries and provide direct aid. Of course this will mean a stronger commitment and investment, but one that will reap huge rewards.
eMile
This program is centered on giving churches the opportunity to ship food, supplies, clothes and Bibles to foreign efforts.
serveNET (Church version)
This program is designed for those who can volunteer time and resources locally. For example: packaging supplies, recruiting sponsors, assisting in fundraisers.
JIA Program MOST interested in:
*
Xport Xtreme
ServeNET
eMile
Click to edit this text...
Additional Programs interested in: ( Check all that apply)
Xport Xtreme
ServeNET
eMile
Spiritual Information
How regularly do you attend church
1- 3 times a week
Once a month
Occasionally
If yes, list Home Church
Church Address or City
Which church services do you attend?
English Services
Spanish Services
Bible Studies
Other Activities
How long have you attended
Less than a year
1 - 5 years
5+ years
Do you serve in any volunteer/leadership role in any ministry or outside the church?
Please name a Pastor or leader who could give you a reference:
Please list two people who know you and your spiritual walk (name and phone #)
Have you ever served on a mission trip, or had any cross-cultural experience?
Yes
No
If yes, where and when? Please explain briefly why you want to participate in this mission trip.
Work Experience / Talents
Please list any specific talents that you have. (drama, singing, instruments, construction, medical, teaching, ministering to children)
Where are you employed?
What position & how long?
Do you speak any foreign languages fluently? If yes, list them.
Health Information
Do you have any condition which might affect your ability to fully function as a missionary on this trip (i.e., fear of flying, depression, anxiety, sleeping disorders)?
Are you presently under medication prescribed by a doctor?
Yes
No
Do you currently have Health Insurance
Yes
No
Personal Information
What are your personal expectations for this trip?
If you are applying for a trip that includes ministry to children, you may be required to have a background check. Will you agree to a check?
Yes
No
What are the most significant events that have occurred in your life in the past two years?
Jordan International Submission Agreement
Would you like updates on projects , events on news from JIA?
*
Yes
No
Jordan International Aid requires compliance with rules and regulations, including the rules concerning conduct, dress and Christian lifestyle. These are explained in the Team Covenant, which will be provided to accepted team members. Failure by team members, leaders and staff to comply with these policies is grounds for dismissal. Team members, leaders, staff and volunteers serve at their own risk, and Jordan International Aid is not liable in the event of sickness, accident, death, or terrorist acts or for transportation and any other expense beyond normal involvement. We require all participants to be in good physical condition, and we may require a doctor’s reference and exam. I have read and understand the above information. The information I have given Jordan International Aid is accurate and true to the best of my knowledge. By completion and submission below it signifies my approval of all limitations listed above.
Submit
...
Click to edit this text...
Should be Empty: