Registration Form for Young Mercy Leaders 2018 Pilgrimage
31 July 2018 - 3 August 2018
Mercy International Association will be delighted to welcome Young Mercy Leaders, aged 18-25 and their accompanying mentors, to Dublin for the 2018 Young Mercy Leaders Pilgrimage.
This form needs to be completed online by every person registering, including staff, volunteers and presenters.
First name *
Your answer
Surname *
Your answer
How would you like your name to appear on your name badge? Include title if desired.
Your answer
Email address *
Your answer
Gender
In what role are you attending the pilgrimage? *
Mobile phone number (please include country code and area code)
Your answer
Date of Birth
MM
/
DD
/
YYYY
What country do you live in? *
Your answer
Are you attending with a group/delegation e.g. Carlow University, Pittsburgh
Next
Never submit passwords through Google Forms.
This form was created inside of Mercy International Association. Report Abuse - Terms of Service - Additional Terms