Mission Trip Application (Mission Trips)

Please select the trip for which you are applying:

First Name:

Middle Name:

Last Name:

Preferred Name:

Gender:

Female
Male

Please enter your date of birth in mm/dd/yyyy format:

Street Address:

Apartment #:

City:

State:

Zip Code:

Email Address:

Primary Phone #:

Full name as it appears on your passport:

Secondary Phone #:

Passport #:

Passport Expiration Date:

What airport would you like to depart from?

General Health:

Please list any allergies:

Will you get recommended vaccinations?

Yes
No

Do you have special dietary needs?

Yes
No

Have you ever been convicted of a crime?

Yes
No

In order for your application to be approved we will need at least two letters of reference from a pastor, counselor, elder, bible study leader, Young Life leader, etc. Please list them in the space provided. Have the letters sent to the address listed on this application or by email to amanda.lawrence@visitingorphans.org (No family references)

Church Affliation:

Church Phone #:

Please list any previous mission trip/overseas experience:

Please succinctly describe why you want to visit orphans:

Are you willing to work as a member of a team with a Christ-like attitude?

Yes
No

Are you willing to follow the authority of the Mission Trip Team Leader?

Yes
No

Please list any gifts and abilities you can offer the team:

Please list your emergency contact information: (Name, Relationship, Phone )

How did you find out about this particular trip?