Pastors R&R » Guest Application

Guest Application

Please complete the entire application as all fields are required.

Guest Application

Your Name *
Spouse
Address of Residence *
Church/Ministry *
Position *
Full Time
Part Time
Address of Ministry *
Email (valid email required)
Phone (Home) *
Phone (Church) *
Phone (Cell)
Phone (Fax)
What is the best way to reach you?

Alternate (Emergency) Contact

Name *
Relationship
Phone *

Other Information

Please list all children and ages in the box below.
Children
When was the last time you had a vacation?
If accepted into the Pastors R&R program , when would you like to get away (approximately)?
From (first day of vacation)
To (last day of vacation)
No particular time, our schedule is flexible.
Would you be planning to fly or drive?
Drive
Fly
Special needs (e.g. handicapped accessible locations, etc.)
Greatest challenge at this time
How did you hear about the Pastors R&R program?
Has Pastors R&R sent you on a vacation in the past? If yes, where and when?
Your total* annual income
*You must include each of the following: Housing allowance, car/travel allowance, vacation package (excluding paid time off), insurance and/or retirement benefits, and additional benefits.
Your spouse’s total* annual income, including benefits
To be considered for the Pastors R&R program, we require you to complete the following:
Do you and the church/ministry you lead believe in the following truths? Please check the box if you believe each statement.
The Bible is the inspired and inerrant Word of God.
The virgin birth, death, burial and resurrection of Jesus Christ.
Jesus Christ will return to earth to judge the world.
Jesus Christ is the only way to salvation; an individual is saved by grace through confession and repentance of their sin, and by placing their faith in Jesus Christ.
All men and women will spend eternity in heaven (a place of eternal joy) or hell (a place of eternal torment.)
The Bible should be our sole guide in matters of doctrine.

References (other than family)

* The 3 references are required to complete application. Thank you. *
Reference 1
Name *
Relationship *
How Long? *
Address *
Phone *
Reference 2
Name *
Relationship *
How Long? *
Address *
Phone *
Reference 3
Name *
Relationship *
How Long? *
Address *
Phone *

Signature

By entering my name below, I hereby declare that all of the information I have provided in this application is true and accurate to the best of my knowledge.
Signature *