Application Request

If you would prefer to have an application packet mailed to you instead of

downloading a pdf to print and fill out, please fill out the form below and click submit.

Full Name

First Name Last Name

E-mail

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number

Area Code Phone Number

When is the best time to call?

What is your age?

Name of church you attend:

I am applying as:

Individual Family Group (church, college, etc.)

Length of trip desired:

2 weeks 4 weeks Other (indicate in comments)

Country of preference (1st choice)

Country of preference (2nd choice)

Country of preference (3rd choice)

Please share any information that will help us match you with the camp or
ministry that would best fit your interests. If applicable, please include names
of specific overseas IM staff that you know and would like to work with.

Additional Comments

Enter the message as it's shown *

Personal Information