ROH (GA) Haiti/Dominican Republic Mission Trip

Name*

First NameLast Name
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Phone*
Email*
Mission Cost: $2000.00 based on 10 (ten) travelers (includes $350 non-refundable deposit, airfare, housing, ground transportation, meals during Mission, project fees)
Payment Dates
December 17, 2023 ($350 Non-refundable deposit due)
January 28, 2024
February 25, 2024
March 24, 2024
April 28, 2024 (final payment due)
Payment Schedule*
Other payment amount*
Total*
Payment Total

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USDHaiti/Dominican Republic Mission Trip
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