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Due to Covid-19 restrictions in Cuba, this ministry trip may be postponed. In the event of the trip being postponed, we can hold your deposit until the trip or refund you the full amount.
Dates of Trip*
First Choice of Departing City*
Second Choice of Departing City*
Name (exactly as it appears on your passport)*
First Last
Nickname
Note: Nickname will appear on nametag
Gender*
- Male
- Female
Date of Birth*
Date Format: MM slash DD slash YYYY
Were you born in Cuba?
- Yes
- No
Occupation*
If A Medical Professional, Please Indicate Your Field

Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Primary Phone*
Secondary Phone
Email*
Link to Facebook Profile
Passport Number
Passport Expiration Date
Date Format: MM slash DD slash YYYY
Emergency Contact Name
First Last
Emergency Contact: Relationship
Emergency Contact: Phone
If Married, Does Your Spouse Support Your Participation?
- Yes
- No
Spouse's Name

Have You Previously Traveled With GMA?
- Yes
- No
If Yes, Give Dates...
Are You Willing To Minister Consistent With GMA's Guidelines
- Yes
- No
Are You Willing To Submit To Being Monitored and Lovingly Corrected If Necessary?
- Yes
- No
How Would You Describe Your Temperament?
Do You Have Any Physical Disability?
- Yes
- No
If "Yes", Please Explain...
Have You Ever Been Treated For A Mental / Emotional Condition?
- Yes
- No
If "Yes" Please Explain...
Please List Any Condition(s) That May Limit Your Participation:
Please List Any Medication, Allergies To Food, etc.
Medical Insurance Provider
Policy #

Church Name
Denomination
Church Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
How Long Have You Attended?
Name of Pastor
First Last
Phone
Are You Born Again
- Yes
- No
- Unsure
Are You Spirit-Filled
- Yes
- No
- Unsure
Do You Attend Church Regularly?
- Yes
- No
Have You Been Water Baptized?
- Yes
- No
Have You Been Baptized in the Holy Spirit?
- Yes
- No
In What Areas of Church Life Are You Currently Serving or Have Served in the Past?
What Do You Believe Are Your Spiritual Giftings?

Have You Received Ministry Training in the Area of Healing?
- Yes
- No
If So, Please Describe:
Have You Received Any Other Christian Ministry Training?
- Yes
- No
If So, Please Describe:
Testimony
Please briefly share your testimony.
Are You Fluent in Any Other Languages Other Than English?
- Yes
- No
If So, Which Language(s):
Shirt Size*
- Small
- Medium
- Large
- XLarge
- XXLarge
*
- I declare that the information provided is true, correct, and complete to the best of my knowledge. I authorize Global Mission Awareness to verify any and all information provided above.
Date
Date Format: MM slash DD slash YYYY
Trip Deposit*
Price: $50.00

Trip Deposit Payment

Click Here to Pay Trip Deposit $50