Short-term Mission Trip Application

Short-term Mission Trip Application
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Date of Birth*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Marital Status

SingleMarried
Gender

MaleFemale
Occupation
Physical Fitness Condition

PoorFairGoodExcellent
Briefly describe any medical conditions or disabilities.
If you speak any other languages besides English, list below.
List any previous mission trip experience.
What church are you presently attending? Are you involved in any responsibilities or ministries in that church?
Select the trip: (All trips are full except Togo)*

Togo: January 8-17, 2025
Why do you want to participate in this mission trip?
*Deadlines to sign up for these trips:

Deadline for Ecuador: August 16

Deadline for Egypt: August 24

Deadline for Togo: October 4

Deadline for Northern India, Himalayan Region (Ages 21 – 55): December 13

Costs:

Ecuador: $1,650 for all in-country costs (Not included: spending $, air travel to Quito)

Egypt: $1,400 for all in-country costs (Not included: spending $, air travel to Cairo, and equipment needed for training)

Northern India, Himalayan Region: $2,750 for all in-country costs (Not included: spending $, air travel to Delhi, and 2-3 optional days of tourism)

Togo: $1,250 for all in-country costs (Not included: spending $, air travel to Togo)

Once we receive your submission, we will give you a call to follow up.
Should be Empty: