Student Information from Parents
We are committed to helping your student learn and grow in his faith journey. Prayerfully, this trip presents an opportunity to engage your student in new situations that will move her faith into the next level of discipleship.

To help us in our interaction with your student, please describe your student in the specific areas of development listed below. Keep in mind that this form is intended as a tool, allowing you to express to us any comments, concerns or special needs for your student.

All information will remain confidential with the World Impact Committee, and if deemed appropriate, with approved team leadership. If you have any questions, please contact the Missions Office at or (630) 668-0878, ext. 191.
Email address *
Parent name (completing the form) *
Student Name *
EMOTIONAL/MENTAL (Are there issues in the home or at school that we need to be aware of that can/may affect his/her behavior or ability to function in a group setting?) *
SOCIAL (How well does your student function in social settings? What word(s) comes to mind to describe your student, e.g., shy, social butterfly, awkward, outgoing, reserved, natural leader?) *
PHYSICAL (physical limitations to the tasks in which the team will be involved) *
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