Mocha Club JOURNEY
JOURNEY to Kenya & Ethiopia

Statement of Interest | Date of Trip: June 12-23, 2016

First Name *
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Last Name *
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Middle Name (ONLY if it appears in your Passport)
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Street Address *
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City *
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State *
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Postal Code *
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Email Address *
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Phone Number *
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Date of birth *
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Gender *
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Country of Citizenship *
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Passport Number (write N/A if unavailable & must apply for one asap) *
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Passport Expiration Date
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How did you hear about the trip? *
How are you at relating to all age groups? *
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How are you at receiving conflict resolution? *
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How are your skills in communication? *
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How are you at adjusting to foreign cultures? *
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How do you handle team work? *
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How are you at adapting to all personality types? *
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How are you at initiating conflict resolution? *
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How are you at creativity? *
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How do you handle living in difficult conditions? *
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*Please Comment on any of the above:
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Motivation: Why do you want to take this journey? *
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Challenges: What challenges do you anticipate? *
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Expectations: What are your expectations of this journey? *
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Strengths: What strengths do you bring to the team? *
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Have you been on a mission trip before? *
If yes, please indicate when and where you went, with what organization, and the purpose of that trip:
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