Personal Information

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Gender *
Marital Status *



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Have you been on a trip with Liberty before? *

Emergency Contact Information

Health Information

Describe Your Health *

References (please provide two)

First reference must be a member of Liberty Baptist Church. Family members will not be accepted as a reference.

Church Background and Salvation

I attend Liberty *
Campus Attended *
How do you plan to pay for this trip? *

What We Believe

The following represents the beliefs of Liberty and the Missions Ministry. If you agree, check the last box that says "Agree with All." If there are any exceptions, list those below. Exceptions do not necessarily mean you will not be able to go with Liberty on this trip.
Agreement *
A deposit of $100 is required to make this application active.  You can give that to the Missions Administrative Assistant or you can drop it in the missions drop box in front of the Missions Center.
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