Missions Long-Term Support Application – Christ Community Bloomington

Please read the Christ Community Church Missions Purpose Statement, then complete this form.

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- Step 1 of 9

Name *

First

Last

Date of birth *

Marital status *

Single
Married
Widowed

Were you ever divorced?

Present address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Email *

Permanent address (if different from above)

Address Line 1

Address Line 2

City

State

Zip Code

Home phone (if different from above)

Names and ages of children

How do you plan to meet the educational needs of your children?

What is your connection to CCC and how long have you been associated with our church? *

Location(s) where you plan to minister: *

Briefly describe the specific ministry you will be engaged in. *

How long are you planning on being there? Initial commitment? *

Mission organization *

Mission organization's address *

Address Line 1

Address Line 2

City

State

Zip Code

Mission organization's email *

Mission organization's phone *

Mission organization's webpage URL *

Describe specific ways in which you will be accountable to this organization (newsletters, financial reports, visits, team on the ground, etc.) *

Is this organization accredited with the ECFA? *

If you have changed from one mission agency to another, please state the reason for the change. (copy)

Please give specific instructions of how, to whom, and when your funds are to be sent/handled. (All monies must be designated to a mission agency or campus ministry.)

Home church, if other than CCC

Home church's address

Address Line 1

Address Line 2

City

State

Zip Code

Home church's email

Home church's phone

Pastor

Describe your relationship with the local church, including areas of ministry and leadership. *

Education and work experience *

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Educational Experience

School #1 name, city, state

School #1 dates attended

School #1 major/minor

School #1 degree

School #2 name, city, state

School #2 dates attended

School #2 major/minor

School #2 degree

School #3 name, city, state

School #3 dates attended

School #3 major/minor

School #3 degree

School #4 name, city, state

School #4 dates attended

School #4 major/minor

School #4 degree

Work Experience

Please list most recent first.

Company #1 name

Company #1 position held

Company #1 dates of employment

Company #1 contact person

Company #1 phone

Company #2 name

Company #2 position held

Company #2 dates of employment

Company #2 contact person

Company #2 phone

Company #3 name

Company #3 position held

Company #3 dates of employment

Company #3 contact person

Company #3 phone

Company #4 name

Company #4 position held

Company #4 dates of employment

Company #4 contact person

Company #4 phone

List any other pertinent training, talents, or experiences (including other missions or cross-cultural experiences).

How well do you know the culture and language of the place to which you will be going? *

Please provide an itemized description of your agency's recommended MONTHLY support (in USD).

Salary

Housing

Children's education

Employee payroll tax

Retirement

Conferences/seminars

Holiday

Medical insurance

Employer payroll tax

Furlough/home service

Administrative overhead

Personal debt

Other expenses (please describe)

MONTHLY TOTAL *

What is your current monthly support level (already raised)? *

References

Please provide three references who can comment on your spiritual maturity and qualifications for ministry.

Reference #1 name *

First

Last

Reference #1 phone *

Reference #1 email *

Reference #2 name *

First

Last

Reference #2 phone *

Reference #2 email *

Reference #3 name *

First

Last

Reference #3 phone *

Reference #3 email *

CCC has committed to focusing our missions efforts on the following areas of ministry:

1) To ministry in a university or educational context. 2) To ministry in the international community in Bloomington. 3) To ministry to people groups and/or communities in extreme physical/material poverty. 4) To minister to people groups with little or no access to a local evangelical church, with the goal of church-planting.

Please describe how your long-term ministry plans fit with one or more of these areas of focus. *

CCC has also committed to "doing missions" in a way that expresses the following values.

Please describe how your long-term ministry plans correspond with these values.

1. Holistically: Reaching out to individuals and communities with the whole gospel in both word and deed. *

2. Targeting Self-Sustaining Solutions: Honoring the dignity and giftedness of those being served by encouraging their insight and active participation in the process of improving their own situation. *

3. Towards Lasting Change: Seeking transformation and development that will have a long-term impact upon people and communities. *

4. Building the Church: Committed to building, establishing, and/or working in cooperation with the local church. *

5. Together with Christ Community Church: Committed to building a long-term relationship and partnership with our church - not just funding. *

Briefly describe your walk with the Lord: How did you come to know Him as Savior and Lord, and what does this mean for you on a regular basis? *

Briefly describe the reason you feel called to go on the mission field. What are the mid- and long-term goals or vision you want to work towards? *

Please make any additional comments that you feel would be helpful to the Missions Committee.

Spouse's Information

Spouse's Information (click "Next" if not applicable)

Spouse's name

First

Last

Spouse's date of birth

Date of marriage

Were you ever divorced?

Spouse's education and work experience *

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Spouse's Educational Experience

Spouse's school #1 name, city, state

Spouse's school #1 dates attended

Spouse's school #1 major/minor

Spouse's school #1 degree

Spouse's school #2 name, city, state

Spouse's school #2 dates attended

Spouse's school #2 major/minor

Spouse's school #2 degree

Spouse's school #3 name, city, state

Spouse's school #3 dates attended

Spouse's school #3 major/minor

Spouse's school #3 degree

Spouse's school #4 name, city, state

Spouse's school #4 dates attended

Spouse's school #4 major/minor

Spouse's school #4 degree

Spouse's Work Experience

Please list most recent first.

Spouse's company #1 name

Spouse's company #1 position held

Spouse's company #1 dates of employment

Spouse's company #1 contact person

First

Last

Spouse's company #1 phone

Spouse's company #2 name

Spouse's company #2 position held

Spouse's company #2 dates of employment

Spouse's company #2 contact person

First

Last

Spouse's company #2 phone

Spouse's company #3 name

Spouse's company #3 position held

Spouse's company #3 dates of employment

Spouse's company #3 contact person

First

Last

Spouse's company #3 phone

Spouse: List any other pertinent training, talents, or experiences (including other missions or cross-cultural experiences).

Spouse: How well do you know the culture and language of the place to which you will be going?

Spouse: Describe how you plan to be involved in ministry.

Spouse: Please give a brief description of why you want to go into mission work.

Spouse: Please describe your walk with the Lord. How did you come to know Him as Savior and Lord, and what does this mean for you on a regular basis?

Doctrinal Beliefs/Statement of Faith

Please consider the following questions carefully. If you fully agree, check YES; if you disagree or agree only in part, check NO and write a brief explanation.

Do you believe the Scriptures, both the Old and New Testaments in their entirety, to be the verbally inspired Word of God, inerrant in the original writing, the complete revelation of His will for the salvation of the world, and preseved by God throughout the ages to be the divine and final authority for all faith and life? *

If no, please explain.

Do you believe in one God, Creator of all things, infinite, perfect, and eternally existing in three persons: Father, Son, and Holy Spirit? *

If no, please explain.

Do you believe that Jesus Christ is God incarnate, that He was born of a virgin, lived a sinless life, died on the cross as a sacrifice sufficient for the sins of the world, rose bodily from the dead, and ascended into heaven, where He serves as our Mediator and Intercessor with the Father until He returns at the end of this age? *

If no, please explain.

Do you believe that the present ministry of the Holy Spirit is to reveal the glory of the Lord Jesus Christ, to convict individuals of sin, to regenerate the sinner who believes, and to indwell, guide, instruct, and empower the believer for godly living and service? *

If no, please explain.

Do you believe that man was created in the image of God and that his subsequent willful sin resulted in physical and spiritual death and in the necessity of a new birth? *

If no, please explain.

Do you believe that the shed blood of Jesus Christ and His resurrection provide the only ground for salvation; that salvation is by God's grace alone, complete and eternal; and that only as one receives this gift of God through personal faith in Christ is one born of the Holy Spirit and made a Child of God? *

If no, please explain.

Do you believe that water baptism and communion are ordinances of the church during the present age? *

If no, please explain.

Do you believe that the church universal is composed of all persons who have been born again through saving faith in Jesus Christ and have therefore become members of the Body of Christ, of which He is the head? Furthermore, do you believe that the local church should be the visible expression and should fulfill the purpose of the church universal in the world? *

If no, please explain.

Do you believe in the imminent, bodily return of our Lord Jesus Christ and that this expectation should encourage the believer to lead a godly and fruitful life? *

If no, please explain.

Do you believe in the bodily resurrection of all the dead: of the believer to everlasting blessedness and eternal life in the presence of God, and of the unbeliever to judgment and everlasting punishment apart from God? *

If no, please explain.

Signature

I/we understand and am/are in agreement with the preceding doctrinal statements that have been indicated with "Yes," and if at any time there is a change in my/our beliefs I/we shall make it known to the Missions Committee of Christ Community Church. I/we have also read the Christ Community Missions Purpose Statement and understand the church's Missions policy.

Letters of Recommendation

Letters can be emailed to missions@cccbloomington.org or mailed to Christ Community Church at 503 S. High St., Bloomington, IN, 47401.

Please provide a written personal recommendation from your sending agency. *

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If a CCC pastor, elder or Missions Committee member knows you well, please also include a letter of recommendation from them.

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I am not well known by a CCC pastor, elder, or Missions Committee member

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Pursuing Christ, Together

Sunday Mornings

Sunday Mornings

Educational Experience

Work Experience

Please provide an itemized description of your agency's recommended MONTHLY support (in USD).

References

CCC has committed to focusing our missions efforts on the following areas of ministry:

CCC has also committed to "doing missions" in a way that expresses the following values.

Spouse's Information

Spouse's Information (click "Next" if not applicable)

Spouse's Educational Experience

Spouse's Work Experience

Doctrinal Beliefs/Statement of Faith

Signature

Letters of Recommendation

Christ Community Church exists to reflect the redeeming grace and transforming truth of Jesus Christ in a college town.