Rancho 3M Trip Sign-Up

Rancho 3M Service Trip

This is the sign-up form for the January 2019 service trip to Rancho 3M in Juarez, Mexico.
Section 1: Personal Information

This information is required for insurance purposes and practical organization of the trip.
Name *

First Name Last Name

Address *

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

Phone Number *

- Area Code Phone Number
Email
example@example.com
Date of Birth *

- Month - Day Year
Date
Food/Other Allergies
Please list all significant allergies.
Do you have a passport?

Yes No
Don't Have A Passport?

A U.S. Passport is required for citizens to return to the United States.
To begin the process of acquiring one, visit:
https://travel.state.gov/content/passports/en/passports.html

Note: either the Passport Book OR Card are sufficient for this trip.
Are you the owner of a vehicle we could use for the trip to Mexico?

Yes No
Make/Model/Year
Passenger Capacity
Car-top Carrier Compatible?

Yes No
License Plate Number
Do you have a car-top carrier we could use?

No Yes

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