2019 LIFO Missions Volunteer Application
Thank you for your interest in joining us on a LIFO Missions Service Trip! Completion of this application does not guarantee a spot on our roster. You will be notified by email on the status of your application.

Trip Dates:
Wed., July 24th - Sat., Aug. 3rd, 2019

Trip Payment Info:
Application Fee: $50.00 (Due at time of submission)
Trip Payment #1: $700.00 (Due by January 15, 2019)
Trip Payment #2: $500.00 (Due by April 15, 2019)

- Any applicant under the age of 18 yrs. must be accompanied by a parent or guardian.
- All applications must be submitted on-line by January 15, 2019.
- A decision on acceptance will not be made until the end of December.
- As always we will have more applicants than spots on this year’s roster.
- The trip will be capped at 30 volunteers so spots will be limited.

Email address *
Name of Participant *
Preferred Name
Email *
Address *
Please include City, State, and Zip Code
Phone Number *
Date of Birth *
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Gender *
T-Shirt Size *
Photo of Participant
Emergency Contact Name *
Emergency Contact Phone Number *
Emergency Contact Email *
Relationship to Participant *
Full Name as it Appears on Passport *
State of Residence *
Passport Number *
Citizenship *
Date of Expiration *
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Picture of your Passport
Have you ever been medically diagnosed with any of the following conditions? (Check all that apply.) *
Required
List any major accidents, illnesses or operations you have had in the past five years. *
List any/all physical/mental limitations or medical conditions that may restrict your ability to climb/carry equipment/perform manual labor on this expedition. *
List any/all medications (including prescription medication) that you will be taking on this trip and why: *
List any/all allergies to food and/or medication: *
Dietary Restrictions *
Are you familiar with standard first-aid and current CPR techniques? *
Do you carry any medical insurance? *
Have you ever traveled abroad? *
Highest level of Education *
Languages Spoken *
Required
Have you participated on any short-term mission trip before? Have you volunteered in the past? (Explain) *
In a paragraph, please tell us why you would like to participate on a LIFO trip? What do you hope to gain from this experience? *
How did you hear about LIFO Missions? *
Required
Have you ever been convicted or pled guilty or no contest to a charge involving any offense against a minor/sexual offense/felony? *
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