• Depart for Field

    Please return this form 1 month prior to your departure.
  • Select correct Assignment*
  • Use the Save and Add Row button to enter all names of those traveling.
  • If you don't use the save button on each row, we will not receive your info.

  • Departure info

  • Departure date
     - -
    2 digit month, 2 digit day, 4 digit year
  • Transportation means
  • Flight details:
  • If you don't use the plus button for each row, we will not receive your info.
  • Field mailing address
  • Address effective
     - -
    2 digit month, 2 digit day, 4 digit year
  • Location address (if different from mailing address)
  • Field phone
  •  -

  • Stateside Emergency Contact
    Name   
    Phone      
    Email         
    Relationship        

  • Current Support
    Need level $
    Support promised $  

          

  • Have you discussed with GFA home office estimated quarterly tax payments to the IRS?
  • Passage funds in? (Including 60% of return flight)

  • Financial arrangements

    First deposit following arrival starting   
    Changes from the usual arrangements?       
    Deposit the balance to checking account
    Bank
    Account #     
    Routing #      

  • Do you have any debt(s)?       
    If so, to whom?
    For
    Amount    
    Repayment schedule      

  • Life insurance in addition to GFA group policy if applicable.
    Company
    Amount
    Address                  

  • Short-Term to complete

  • All book summaries turned in to Dr. Berrey?
          
    If no, please explain.

  • Return Date
     - -
    2 digit month, 2 digit day, 4 digit year
  • Special assignment reminders
  • First time to the field?

  • Please click the submit button when done.

  • First time to field to complete

  • Retirement Program

    Company   
    Amount deposited monthly $   
    Address                
    Account #      

  • Commissioning service
  • Ordained since application submitted?

  • Please click the submit button when done.

  • Should be Empty: