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1
How excited are you to team up with Clinic-on-the-
G0
to make 6X your Kenya mission trip impact?
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Totally pumped! I want to bring dental care to amplify out outreach!
Pretty interested--tell me more about how this can be a game changer!
Just exploring, but curious about the possibilities.
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2
Were you already aware dental campaign massively increase turnout for evangelism events before finding us today?
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Yes
No
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3
What is your role in the mission trip?
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Pastor / organizer leading the flock with vision.
Youth Leader / Organizer inspiring the next generation.
Health Ministry Leader / Organizer providing hope and health stewardship to others.
Volunteer/Helper with a heart for service. Without you, none of this is possible. Truly.
Dental Professional bringing the right arm of the gospel, dental instrument in hand.
Medical Professional bringing the Right Arm of the gospel
Mission Trip Coordinator planning epic adventures!
Other
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4
If other, what role would you have in the mission trip?
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5
What is your interest level in providing Dental care as an evangelistic tool?
0 = Not really interested, but am curious. 5 = Highly interested, it's just what we need!
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6
When are you planning, or considering a mission trip to Kenya?
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Within the next 6 months--let's make it happen!
6-12 months from now--planning ahead!
Over a year away--dreaming big for the future!
Not sure yet, but I'm open to ideas!
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7
How many volunteers will be on your team?
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Small but mighty (1–5 people).
Growing crew (6–10 people).
Big impact squad (11+ people).
I'm still exploring this as an option
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8
Have you organized mission trips with dental or health outreach before?
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Yes, we’re pros at health-focused missions!
Kinda—tried it once or twice!
Nope, this is a fresh adventure for us!
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9
Do you already have a set travel date??
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If yes, type in your travel dates, please
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10
Have you ever been responsible to organize and fund-raise for a dental clinic --- *in the USA*?
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Yes
No
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11
Who is the decision-maker for your mission trip?
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Name / Role or position
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12
What is your estimated budget for dental clinic services?
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Please Select
$2,000 -$5,000 USD
$5,000-$10,000 USD
$10,000-$15,000 USD
$15,000 - $20,000 USD
Please Select
Please Select
$2,000 -$5,000 USD
$5,000-$10,000 USD
$10,000-$15,000 USD
$15,000 - $20,000 USD
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13
Thank you so much for telling us more about you and your interest. Kindly tell us who you are by providing your name
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First Name
Last Name
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14
We will send you a short video with more information. Please provide your best Email.
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example@example.com
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15
JUST ONE MORE QUESTION: Being that this is an International event, we'd love to know where you are from. Kindly provide your Country of Residence:
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6X Your Next Mission Trip Turn-out with Dental Health Outreach!
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