2023 Central American Pilgrimage Questionnaire Jan  9-20 , 2023
Suggested donation $1,100 to cover costs - contact Kris East at keast@maryknoll.org or (510) 276-5021 for questions or assistance with this form
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Email *
First Name *
Last Name *
Street Address *
City *
State *
Zip Code *
Phone number *
Diocese *
Age *
How did you hear about this trip? *
How certain are you about going on this trip? *
Very certain
Still Deciding
Tell us more why do you want to go on this trip? *
Please give us a brief biography (i.e., 1/2 page) *
What kind of ministries or service projects are you involved with? *
What is your experience with cross cultural encounters? *
What do you hope to do with this experience when you return? *
What is your experience and familiarity with Maryknoll? *
Have you been to these countries before? *
Are you fluent in Spanish?
Clear selection
What is your experience with travel outside the U.S.? *
Will your physician clear you to participate in this pilgrimage? (If accepted you will be asked to submit a medical release signed by your physician) *
Do you have any mobility or other medical restrictions that impact your ability to participate fully? If so please explain. *
Do you have any dietary restrictions? If so please explain. *
When is the best time to contact you to talk more about the trip *
What questions do you have for us?
A copy of your responses will be emailed to the address you provided.
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