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.
Personal Information
Full Name

First NameLast Name
E-mail
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
When is the best time to call?
What is your age?
Name of church you attend:
I am applying as:

IndividualFamilyGroup (church, college, etc.)
Length of trip desired:

2 weeks4 weeksOther (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*
Should be Empty:

Personal Information