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Mission Application

HOLY FAMILY/INCARNATION PARISH MISSION

Missionary Application

Thank you for expressing an interest in joining one of our mission trips to Cevicos, Dominican Republic. Please fill out the form below so that we can consider you for an upcoming trip. The Executive Committee of the Mission, based at Holy Family in Gloucester, is responsible for determining the team for each trip depending on need and focus. Those with a skill set that most benefits the purpose or focus of a particular mission trip will be given preference.

NAME

STREET ADDRESS

CITY/STATE/ZIP

EMAIL (used for all meeting notices and other communication)

HOME PHONE

OTHER PHONE #s

CONTACT INFORMATION (in case we need to contact a family member during a mission trip)

NAME EMAIL ADDRESS

PHONE #s

The focus of our mission is primarily medical but there is need as well for missionaries who are able to translate, organize the trip, keep medical records, assist in the pharmacy, drive one of our vehicles and visit with the people in Cevicos and those who attend our clinics.

Please describe any medical or other special skills that you can offer that may assist the mission.

You may feel that you have limitations that prevent you from participating in a mission trip. How can we address any concerns you might have?

What is your current religious affiliation?

What language(s) do you speak besides English?

Are you able to carry on a conversation in another language?

We typically organize (2) adult trips per year to the Dominican Republic.

Please return this completed form to Father Steve Madden  at Incarnation Parish. Fr. Steve will then forward the form to the Mission Committee at Holy Family in Gloucester.