Online Mission Trip Application

If you are interested in a specific trip, please fill out the information below.  Applications will be held confidential by IMPACT staff and trip leaders.

Which trip are you applying for? Required

First and Last Name (as appears on passport) Required

Address Required

Street Address

City

Select AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY State

Zip Code

Phone Number Required

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Email Address Required

Passport #

Birthdate Required

List any health issues: Required

Occupation Required

Employer Required

College (if applicable)

Degree Earned

Describe how and when you became a Christian Required

Why do you want to go on this mission trip Required

List church involvement/leadership experience

What are some abilities/talents you feel you have?

What do you consider to be your personality type?

What do you hope to contribute to, and gain from this experience?

List any fundraising experience or ideas