Registration - U.S. Mission Trips

 

Group/Organization Name:

*Street Address:

City:

 

State:

ZIP Code:

 

 

 

 

Contact Person - First Name:

Last Name:

Home Phone:

Work Phone:

Cell (inc. Area Code):

Fax Number:

*Email Address:

*Please indicate below how you would prefer to receive most of the material we will send to you:



(Some materials must be sent by U.S. postal service.)

 

 

 

 

Estimated number of Participants:

(We will send you applications based on your estimates)

 

 

Adults:

Teens:

Children (ages 4-10):

Children (ages 0-3):

Which one applies to your team:

Sr. High

Jr. High

Mixed

 

 

 

 

Date for Missions Project:

 

 

Missions Project Location:

 

A $50 non-refundable per person deposit must be sent in addition to this registration Form.

This is the only way to lock in your preferred date as well as space for the number of participants you would like to bring.

Please make the check to World Vision. In the memo section of the check, please put Mission Project and the date of the project. Mail your check to:

World Vision Appalachia
Attn: Kris Wamsley
P.O. Box 162
420 Chestnut Street
Philippi, WV 26416

Phone: 304.457.5270 ext. 289

Fax 304.457.6747

NOTE: Your reservation will not be official until we receive your deposit. Once we receive your registration form and deposit, we will send you a 'Group Mission Project Contract' as well as more details for your mission project.

E-signature:

Organization Contact Person Signature:

Date (mm/dd/yy):

Do you require a printed copy of your registration for your records?