2019 summer missions application

This year we are participating in the LOVE THE HILL SUMMER OUTREACH right here in Harrisburg, PA. We will be spending a week at the Wild Heart Ministries House, commonly know as The Mansion, doing service projects and evangelism.

FOR REGULARLY ATTENDING HEIRBORNE YOUTH STUDENTS AGES 13 AND UP

WILD HEART MINISTRIES
333 S 13TH ST
HARRISBURG, PA

JULY 29 - AUGUST 3
$400 PER STUDENT

APPLICATION, $50 APPLICATION FEE AND ONE PERSONAL RECOMMENDATION ARE DUE BY MAY 1
IF ACCEPTED, ADDITIONAL $50 DEPOSIT IS DUE BY MAY 1
REMAINING $300 IS DUE BY JULY 17

PAYMENTS CAN BE MADE VIA CASH, CHECK OR CREDIT CARD USING AN HEIRBORNE PAYMENT ENVELOPE.
ENVELOPES CAN BE FOUND OUTSIDE THE YOUTH ROOM OR AT THE WELCOME DESK.

Personal Recommendation Form can be found here.

Please do not close out or refresh this page before submitting the application. We recommend typing longer responses in a separate document in case your application is lost due to internet loss or some other unexpected interruption.

If you have any questions, please contact us here.

Name *
Name
Birthday *
Birthday
Address *
Address
Student's Cell Phone (if you have one)
Student's Cell Phone (if you have one)
Example: Text, Email, iMessage, Text Mom, etc
Parent/Guardian's Name *
Parent/Guardian's Name
Parent/Guardian's Cell Phone Number *
Parent/Guardian's Cell Phone Number
Parent/Guardian's Name
Parent/Guardian's Name
Parent/Guardian's Cell Phone Number
Parent/Guardian's Cell Phone Number
This is only needed for us to be aware of. These types of questions will not be used in the decision for acceptance of your application.
This is only needed for us to be aware of. These types of questions will not be used in the decision for acceptance of your application.
We will be sending out update emails with information, and details your parents will need for the trip and we would like to make sure we are sending them to the parent who needs the updates most. If no parent is specified here, we'll email both.
Expiration Date of Passport
Expiration Date of Passport
If no passport is needed for this trip, please disregard this question.
YOUR SPIRITUAL LIFE
Please check the statement that best describes you. *
Other Personal Informaiton
Health Information
Do you or have you ever had: *