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*All trip requests 22 gty grtijuanauwill be reviewed at an NV 22222× scan/email yryjy cdfr Timj De3svlin at tdevling@2; ND mich yin kuhn undmil <uu<eadventures.org

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*All trip requests 5uuu?icy h kuhn u of Faith, Vision, and Mission.mud

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Cell Phone: _______rj c Occupation: _____________s________________________he222 lb yu vet    __j______ju ssn 44imagesng hhhvhubby vjjjjjyj

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Church address: tyi

St22222222222uate: ________tjk_  gi: ____________  Pastor:hyfkrk5kj ________________t__________________

How 22222 y22222222ou hear about us: __________________________________________________

________r_____r NJ r_____________k ICC yttth k______________________________________________no omitted mann

Have you been yb j MN mm n moo km k or another 2MA Chapter?

__ Yes  __ No  If Yes, What trip did you attend? ___________________________________

Trip You Plan To Run: _______________________________________________________

Location: ____________________________ Length of Trip (i.e. days): _________________

How does Going A New Distance: physically, mentally, and spiritually factor into this trip…

how will you achieve this: ______________________________________________________

__________________________________________________________________________

__________________________________________________________________________

What is your plan for following up with trip participants: ______________________________

__________________________________________________________________________

__________________________________________________________________________

Trip Budget: (i.e. gas, food, apparel, lodging, etc.): __________________________________

Cost Per Participant (we strive to run trip so we break even, we don’t want cost to be a reason

someone doesn’t attend): ____________________________

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Will you need a 2MA h vre

Signature: kium mommy hi innmmvm RV ____________________________________  Date: ________________________

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------------------------------------- For 2nd Mile Adventures Board Use much--------------------------------------

I confirm that the Board of Directors has approved this request for a 2MA Trip.

Board President Signature: ___________________________      Date: _________________

2MA Director Signature: _____________________________        Date: _________________