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Passport Information
I have one.
I do not have one.
Name on Passport
Legal First Name
Legal Middle Name
Legal Last Name
Passport Number
Place of Issue
Expiration Date(DD/MM/YY)
B-Day (as it appears in the passport,DD/MM/YY)
Are you U.S Citizen?
Yes.
No.
Country of Citizenship
Green Card #(If applicable)
Does your military status allow you to go overseas? (Korean male citizen only)
Yes
No, I need to deal it
1st Wave: June 5th, 2010 - July 6th, 2010
2nd Wave: June 26th, 2010 - July 31st, 2010
Country Choice (**your team is subject to change)
--Select Misson Team--
Tonga
EastAsia1
EastAsia2
Japan2
Cambodia
Vietnam
Mongolia
Thailand2
Phillipine
SouthAfrica
AsiaMinor
Interstate1
KoreanConference
Anywhere
NotGoing
Stint2009
Stint2010
Haiti
** Your selection is subject to change.
** Following choices is not for first mission goers.: Japan
** Following choices is only for students who have visa problems.: Interstate
Emergency Contact Person in USA
Emergency Contact Phone Number in USA
Emergency Contact Person in Korea (If applicable)
Emergency Contact Phone Number in Korea
T-shirt Size
S
M
L
XL
Other
Statement of Faith
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Liability Form
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Please turn in: Statement of Faith, Reliability Form, and registration fee along with a copy of this page.