Full name as it appears on passport
Best Contact Number (day)
Best Contact Number (night)
Name of Medical Insurance Co
Insurance Co Phone Number
Have you been on any other mission trip? If so, where? What were you doing? How did it shape your view of mission work?
What do you hope to experience/accomplish on this trip?
What will be the most difficult part of preparing, going, and returning from this trip for you?
How long have you been a follower of Jesus? Have you been baptized as a follower of Jesus? If so, when, where, and how old were you?
Who are two personal references who can attest to your faith in Jesus as Lord and Savior? Enter name, email, and phone.
Is there anyone you think would benefit from a similar mission trip? List 3 names, email, and phone.
Trip cost may change due to hotel cost and airfare. The deposit is non-refundable. Please type "UNDERSTAND" that you understand these disclosures.
Once the form has been submitted you will have the option of paying the full amount for the trip ($3800) or the deposit ($2100). A payment of at least the deposit must be made.
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