Personal Information Spouse Information SingleSignificant RelationshipMarriedDivorcedMultiple Marriages Family Information Term / Field Education Experience Gifts Health / Other Please state any health conditions that you or your family members have. (Include any physical disabilities or history or mental health issues). Are you in generally good health? If no please give details. Are you currently taking any prescribed medication? If yes please give details. How would you rate your general level of fitness? Please mark the areas in which you've had personal experience. AbuseAddictionSignificant Trauma Please mark the areas in which you've had ministerial experience. AbuseAddictionSignificant Trauma Have you ever participated in, been accused of, been convicted of or pleaded guilty to any abuse or sexual misconduct? Faith References Please include at least one employer and one mentor/pastor who have accompanied you in your Christian life and ministry. Terms I agree, if approved to... Attend CI orientation Attend cross-cultural missions training Attend fundraising training Attend Crosstraining at CI mission base in Wilmore, KY Complete a Birkman Personality Profile Complete a Background Check Satisfy personal costs related to preparation, such as, a background check, a Birkman Personality Profile, acquiring a passport/visa and health/immunizations, registration for additional training, etc. Be accountable to the President in determining departure times and dates Raise the required funds and see that they are deposited in my Cornerstone fund prior to departure Abide by the rules & regulations of Cornerstone International I, the applicant named above, warrant the truthfulness of the information provided in this application.I understand that by typing my name and pressing the submit button below constitutes a legal signature confirming that I acknowledge and agree to the above Terms.