Gleanings 2019 Sign Up Form
Our trip this year will be June 8-17th.

Please fill out all of the information and then get the non-refundable deposit of $200 to Marty for your first payment. That will hold your place and allow for airline tickets to be purchased.

The total cost of the trip is around $800, the out of pocket expense will be close to that this year with two major trip going on. National Youth Gathering and Gleanings. That includes air fare, transportation, hotels, side trip, Gleanings expenses. Food except for the time at Gleanings is on your own.

Until your first payment is submitted, you will not be officially on the list of those going. It is still good to sign up to receive the information that will be sent out. You can submit payment via cash, check or by going to paypal.me/ssiah (just add "Gleanings 2019" in the notes)

First Name (Name on your ID.) *
Your answer
Last Name *
Your answer
Birthdate (month/day/year) *
Your answer
Mobile Phone Number (you) *
Your answer
Email Address (you) *
Your answer
Parent Name (Only one is needed) *
Your answer
Mobile Phone Number (for the parent listed above) *
Your answer
Email Address (for the parent listed above) *
Your answer
Shirt size *
Why you want to go to Gleanings for the Hungry? *
Your answer
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