Group Registration

MOBILIZING STUDENTS Mission Trip Registration

MOBILIZING STUDENTS

805 S. Glynn Street

Suite 127, #167

Fayetteville, GA 30214

678.763.2134

www.mobilizingstudents.com

Thank you for your interest in serving on one of our mission trips. To reserve your space, please fill out the information below.

* How are you choosing to register?

(Individual, Student Group, Family, Christian School, Campus Ministry, etc.)

* First Name

* Last Name

List family members & ages (For Family Trips Only)

Title

* Organization

* Address 1

Address 2

* City

* State

* Postal Code

* Business Phone

* Cell Phone

Fax

* Email Address

* Ministry Website/Organization Website

* Mission Trip Location:

[CUSTOM TRIP]: Tell Us Where You Desire To Go?

[CUSTOM TRIP]: Have you been to this location before? List any ministry contacts/connections you have in this city/country.

[CUSTOM TRIP]: Although we will have staff on your trip, do you want us to lead this trip for you, or do you prefer that we simply arrange all logistics/details behind the scenes & allow you to be the up-front leader for this trip yourself?

* Dates of Trip Selected?

* Group Size

Any special needs/requests or concerns we should know about?

* What major airport will you depart from?

* If other airport, list here:

* Have you attended one of our mission trips before?

Yes

No

If you attended, when & where did you attend?

* What specific gifts/abilities does your group have?

* Did anyone refer you to us? If so, please list who?

A per person deposit is due within 30 days of registration. $50 person (US Trips) / $200 person (International Trips)

We will be calling you within the next 48 hours to confirm your registration, arrange your airfare for you, and answer any questions you might have about your trip. Thanks for choosing to serve with us. God bless.

* Indicates Response Required