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Global Missions Partnership Form
1
What's your
name
?
*
This field is required.
First Name
Last Name
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2
What's your
email
, {name:first}?
*
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example@example.com
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3
And your
phone number
?
*
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Area Code
Phone Number
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4
What are your
connections to UMHB
, if any?
*
This field is required.
Current faculty or staff
Former or retired staff
Current student or alumni
I don't have any connections
Other
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5
List your
title
and
department
.
*
This field is required.
Title
Department
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6
List your
degree
and
major
.
*
This field is required.
Degree
Major
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7
Have you identified a
global partner
for your mission trip?
*
This field is required.
YES
NO
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8
How long has this global partner been established?
*
This field is required.
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9
What country
would you be going to for your trip?
*
This field is required.
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10
List
all cities
that you will be visiting during your trip.
*
This field is required.
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11
List the
best possible times
for potential student travel.
*
This field is required.
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12
What's your proposed
date for departure
?
*
This field is required.
-
Date
Year
Month
Day
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13
What's your proposed
date for return
?
*
This field is required.
-
Date
Year
Month
Day
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14
Is there
adequate time
available to plan and raise funds for this trip?
*
This field is required.
YES
NO
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15
Describe the
potential mission opportunities, partnerships, and/or projects
for this trip.
*
This field is required.
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16
What is the
length of time
needed for this trip?
*
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17
Which
academic disciplines
would this trip interest?
*
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18
What
UMHB resources
could you partner with to make this trip more successful?
*
This field is required.
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19
Describe what aspects of this trip will make
UMHB students
want to partake in it.
*
This field is required.
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20
What are the
potential health risks
involved, if any, with the following components?
*
This field is required.
Lodging and location of lodging
Food and water
Medical care nearby
Type of work and the work-site
Transportation
Travel routes around unsafe areas near lodging and work locations
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21
Will the global partner or the UMHB Team Leader be in charge of the following components?
*
This field is required.
UMHB
Global Partner
Lodging and location of lodging
Row 0, Column 0
Row 0, Column 1
Food and water
Row 1, Column 0
Row 1, Column 1
Medical care nearby
Row 2, Column 0
Row 2, Column 1
Type of work and the worksite
Row 3, Column 0
Row 3, Column 1
Transportation
Row 4, Column 0
Row 4, Column 1
Travel routes around unsafe areas near lodging and work locations
Row 5, Column 0
Row 5, Column 1
Lodging and location of lodging
Food and water
Medical care nearby
Type of work and the worksite
Transportation
Travel routes around unsafe areas near lodging and work locations
UMHB
Row 0, Column 0
Global Partner
Row 0, Column 1
UMHB
Row 1, Column 0
Global Partner
Row 1, Column 1
UMHB
Row 2, Column 0
Global Partner
Row 2, Column 1
UMHB
Row 3, Column 0
Global Partner
Row 3, Column 1
UMHB
Row 4, Column 0
Global Partner
Row 4, Column 1
UMHB
Row 5, Column 0
Global Partner
Row 5, Column 1
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22
What is the
minimum number of participants
needed in order for this trip to be successful?
*
This field is required.
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23
What is the
maximum number of participants
that this trip can accommodate for?
*
This field is required.
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