AIM Visitor Application

Name *

Gender *

Male Female

Birthday *

- Month - Day Year

Are you coming with a group? *

Yes No

Who is your AIM host? *

Who is your group or team leader? *

What month is your visit planned for? *

Phone number

Address *

Email *

Current Employment *

What is your highest level of education? *

What is/was your degree or intended major?

Current Relationship Status *

Single In a Relationship Engaged Married Divorced

Do you have children? *

Yes No

Upload a recent photo of yourself: *

If Applicable: Home Church Information (Full name, City, State)

Describe your church involvement. *

Volunteer experience (Include dates, description, responsibilities, etc.) *

Work Experience (Include current employer, previous work experience, companies, location, dates, title, description and reason for leaving) *

International Travel Experience *

Languages You Speak and Level *

Musical Experience *

Hobbies and Interests *

Childcare Experience *

Have you accepted Jesus Christ as your Lord and Savior? *

Yes No I don't know

Your Story *

What are your expectations for this trip? *

Have you ever received help for psychological, sexual, emotional, or relational problems? *

Yes No

Have you ever attempted or considered suicide? *

Yes No

Do you currently have suicidal thoughts? *

Yes No

Have you ever struggled, or are you currently struggling with an eating disorder? *

Yes No

Have you ever been, or are you currently addicted to any of the following? *

Alcohol Prescription Medicines Illicit Substances Pornography None of the above

Have you ever been accused of and/or reported for physically or sexually abusing someone? *

Yes No

Do you have a police record? *

Yes No

Please use this space to further explain any of your responses to the questions above:

Weight *

Height *

Depression and/or Anxiety *

Yes No

Depression/Anxiety Severity

Mild Chronic

Allergies *

Yes No

Allergies Explanation

Please list out all allergies.

Specific Food Allergies *

Yes No

Food Allergies Explanation

Insomnia or Other Sleep Disorders *

Yes No

Insomnia or Other Sleep Disorders Severity

Low Medium High

Asthma *

Yes No

Asthma Severity

Low Medium High

HIV/AIDS *

Yes No

Seizures *

Yes No

Seizures Explanation

Please list out any medications that you are taking for this condition.

Physical Disabilities/Special Conditions

Do you have any physical disabilities or conditions that require special care? If so, please explain.

Communicable Diseases *

Yes No

Communicable Diseases Explanation

Provide specific details here.

Chronic Medical Conditions *

Yes No

Chronic Conditions Explanation

Use this space for further explanation.

Diagnosed Psychiatric Conditions *

Yes No

Diagnosed Psychiatric Conditions Explanation

Use this space for further explanation.

Medications *

Use this space to detail all medications that you are taking currently.

Are you current on vaccinations for Hepatitis A? *

Yes No

Are you current on vaccinations for Tetanus? *

Yes No

Medical Disclosure *

I agree

Name *

Relation to Applicant *

Primary Phone *

Secondary Phone

Email *

Address *

Transportation: Our ministry is about 120 miles from Guatemala City, but takes about 6 hours to drive because of the mountain roads and traffic. If you get car or airsick, please plan appropriately with medicine. While at our mission base, visitors are not allowed to drive any ministry vehicles, four wheelers, motorcycles, construction equipment, or agriculture equipment without special permission because of liability issues.

Housing: Most of our bedrooms will have multiple bunk beds. You will be sharing bathrooms and showers amongst your group. We do have hot water but due to the limitations of water here, we ask that you plan on taking five minute showers. Any personal items that you require will need to be brought with you; ie: shampoo/conditioner, soap, shaving cream, hairdryers, etc. Sheets, pillows, pillowcases and blankets will all be provided, however dependent on the size of your team you may be asked to bring some with you. We also ask that you please do not drink the water from the faucets or the shower. Plan on bringing a water bottle that can be refilled with purified water for drinking.

Laundry: If you are coming for 10 days or less, please plan on not doing laundry while you in Guatemala. If you need to hand wash a couple items, we have a pila (a hand washbasin of sorts that the Guatemalans use) that is available for you to use and we will be more than happy to show you how to use it.

Dress: Our female visitors are required to wear long skirts past the knee while at clinic and in the market. Please do not bring tank tops, yoga pants, short shorts, two-piece swimsuits, etc. Male visitors are required to wear long pants/jeans. On travel days and during Sabbath activities, men and women can wear long shorts. Long athletic shorts can also be worn by if anyone desires to exercise during the trip.

Weather: Guatemala has two seasons – rainy and dry. The weather here is very consistent year-round. It gets a little colder around December, January and February. It is super hot in March and April, usually. The rains start in May and typically last until September. If you are coming during the rainy season, please bring with you a rain jacket or poncho for the afternoons. If you are coming during the winter season (mid-October through February), please also plan on some long-sleeve shirts for the early mornings and evening. Internet/Computers: Our ministry base has wifi; team member use will be at the discretion of your leader/host. We strongly encourage our visitors to take advantage of our isolation and remain unplugged for the duration of their time here.

Tobacco, Alcohol, and Drug Policy: The use of tobacco, alcohol, or drugs is prohibited at any time while you are in Guatemala.

Safety: We view Guatemala as a relatively safe place; however we do ask that you do not leave the compound after dark. Two or more are always the best choice if you decide to go on a walk or to town, and please make sure to let your team leader/host know where you are going even during the daytime hours.

Sabbath: The ministry takes a Sabbath on Sunday. This is a good day to talk through your experiences as a team, journal, spend individual and team time in worship and prayer or have some leisure time. We will give you more details on your schedule as your departure time gets closer.

Thank you for your flexibility!

I have read AIM's Visitor Expectations and agree to abide by these expectations. *

Yes

I certify that I have answered all of the above questions truthfully, completely, and to the best of my ability. *

I have.

Personal History

Personal Faith

Health Evaluation

Medical Release Form

Medical History

Medical Insurance

Emergency Contact Information

AIM's Visitor Expectations