MX/AZ Program Application
We are excited that you are interested in traveling with us! Please fill out this form completely so we might know more about you. Participants will be chosen based on an identified list of skills, demographics, and other criteria needed for this specific project.
If you have any questions while filling out the application you may email

Trip dates: Sept 3-12ish, 2021

Team members are encouraged to fundraise for their trip fee. You can do so on facebook (preferred because they do not charge fees) or we can set you up on a fundraising portal page if you prefer. Approximate cost of trip: $1,300. Due at signing: $250 before May 17 or $400 after. Your deposit fee is included in the overall cost of the trip minus a $50 administration charge. Trip fees include the following for 10 days: airfare, ground transportation, most meals, lodging, taxes and tips.*

Payment Schedule*:
1/3 cost of trip is due by June 15
2/3 cost of trip is due by July 15
Total cost of trip is due by August 15
Daily late fees WILL be assessed.

Applications will be processed once $250 fee is in receipt. Thank you again for your interest!
* Subject to change
Name as it appears on your passport *
Familial name/nick name *
Date of Birth *
Full Street Address *
Email address *
Primary telephone *
(Cell preferred)
Type of phone *
Emergency Contact Name, Phone, Relationship *
How did you find out about this project? *
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