2017 Mission Trip - Information Submission
All those planning to attend a mission trip in the calendar year 2017 are required to send us the information contained in this form.

For those 18 years of age and older, you will have a section of adult-only questions at the end to fill out.

In the event that any of this information changes prior to the mission trip, you must notify LutheranHANDS by emailing the registrar at registrar@lutheranhands.org

First Name *
Your answer
Last Name *
Your answer
Address *
For Example - "1500 W Ohio Street - Apt 1A"
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Home Phone # *
Please include the area code
Your answer
Mobile Phone # *
Please include the area code
Your answer
Email Address *
Your answer
Gender *
When were you born? *
MM
/
DD
/
YYYY
Grade (2015-16 School Year) *
T-Shirt Size *
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