Barrow Mission Trip (June 1st - 17th)
After you complete this form, you will be contacted by a mission leader to complete the process of registration. If you do not receive a response within two days of completing the form, please email kaitlin@collegemissions.net. Thank you!
Name *
full name that is on driver's license/ID
Your answer
Birthday *
MM
/
DD
/
YYYY
Cell Phone Number *
(###) ### - ####
Your answer
Email Address *
Your answer
What college or university are you enrolled in? *
Your answer
What is your anticipated year of graduation? *
Age that you will be on June 1st *
Your answer
Any medical conditions? *
if none, put N/A
Your answer
Any medications? *
if none, put N/A
Your answer
Any food allergies/restrictions? *
if none, put N/A
Your answer
Have you ever been on a mission trip before? *
Required
If you have been on mission before, please list all mission experience with where you went, when you went, and for how long you were there.
(i.e Alaska; May 2016; 2 weeks)
Your answer
Please list and briefly describe any community service experience you have. *
Your answer
Why do you want to go on this mission trip? *
Your answer
What do you hope to bring to the mission trip? *
Your answer
What do you hope to gain from the mission trip? *
Your answer
Please give an employer reference. Please give his or her name and email address. *
Your answer
Please give a personal reference of someone who has known you longer than 5 years. (Cannot be a family member or peer.) Please give his or her name and email address. *
Your answer
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