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Mission Team Member Survey
*
First Name (as shown on passport)
*
Middle Name (as shown on passport)
*
Last Name (as shown on passport)
*
Date of Birth
*
Email
*
Phone
*
Address
*
City
*
State
*
Zip Code
*
Why do you desire to go to Kenya?
*
Got a family member(s) attending? If so, who?
*
T-Shirt Size
select one
Small
Medium
Large
XL
2XL
3XL
4XL
5XL
*
In School
select one
Attend Elementary School
Attend Middle School
Attend High School
Attend College
Nope
*
Occupation
*
Do you attend church?
NO
YES
If you attend church, what is the name of the church?
Are there any special skills or talents you would like to use on the trip?
*
Are you a soccer player?
NO
YES
*
Do you have any fears concerning this trip? (if so please explain)
*
Do you have any allergies or medical issues we should be made aware of? Please list.
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