Vision Trip Registration

Vision Trip Registration

Please fill in the form below.
Full Name - Please enter your legal passport name. This is necessary for us when we purchase your plane ticket. *

Prefix First Name Middle Name Last Name

Address *

Phone Number *

- Area Code Phone Number
E-mail *
What University do / did you attend? *
Year of Graduation *
Which vision trip(s) are you interested in going on? 1st choice *
2nd Choice
Passport
Do you have an updated passport? (Passport's expiration date must be at least 6 months from date of trip. ] *

Yes No
Passport Expiration Date *
Expectations
How did you hear about this vision trip? *
Please list your experience(s) overseas. Where have you been and for what purpose? *
Why do you want to go on this vision trip? What do you hope to gain from the trip? Please be elaborative. *
Support Raising
Have you ever raised support before? *

Yes No
Are you willing to raise the support needed to fund the trip? *
Would you like to receive training on how to raise support? *

Yes No
Should be Empty:

Passport