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Name

Birthdate (YYYY-MM-DD)

Gender

Passport Country

Have you attend any CCBC before?

Marital Status:

How did you hear about CCBC Jerusalem?

Do you know anyone who has attended CCBC Jerusalem? Please list their name below:

Please list any physical handicaps below ( if none, just write no or N/A)

Do you have any health concerns? (if none, just write no or N/A)

Do you have any mental health concerns or learning disablities? Please list below:

Please share a little about your testimony/walk of faith in Jesus:

Please share your beliefs on discipleship and what your personal desire is for discipleship:

Have you ever been in any leadership position, such as a camp counselor, group leader, etc?

Please share what you hope to grow from a semester at CCBC Jerusalem:

Please share about your spiritual gifts/hobbies/interests:

Please share about your characteristics, such as your strengths and weakness and or how you would describe yourself:

Please share what church you attend and what involvement you have:

Please share any concerns that you have:

I agree to the statement above:

Jerusalem Study Tour