MOBILIZING STUDENTS Urban PLUNGE 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
Urban PLUNGE
. To reserve your space, please fill out the information below.
GROUP INFORMATION
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How are you choosing to register?
(Student Group, Christian School, Campus Ministry, etc.)
Student Group
Christian School
Campus Ministry
Other
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Organization
Title
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First Name
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Last Name
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Address 1
Address 2
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City
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State
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Postal Code
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Cell Phone
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Email Address
Your group's website
Your Group's FaceBook Page (if applicable)
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What specific gifts/abilities does your group have?
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Group Size
Any special needs/requests or concerns we should know about?
EVENT INFORMATION
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Choose your week of preference?
June 18-22
Other
If you are a group of 80 or more, and would like us to customize an Urban PLUNGE week for you, please list your Mon-Fri dates and we will contact you to discuss details. (Must be open to other groups joining you during that week).
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Which pricing option would you like?
$295 person (all-inclusive; you provide transportation)
$195 person (you provide your own meals & transportation)
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Do you plan to drive to Urban PLUNGE?
Yes
No
If flying, what major airport will you depart from?
Atlanta, GA
Louisville, KY (for Asbury College)
Dallas/Fort Worth, TX
Denver, CO
Orlando, FL
Other
If other airport, list here:
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Have you attended one of our mission trips before?
Yes
No
If you attended, when & where did you attend?
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Did anyone refer you to us? If so, please list who?
A $50 per person deposit is due within 30 days of registration.
We will be calling you within the next 48 hours to confirm your registration, and answer any questions you might have about your trip. Thanks for choosing to serve with us. God bless.
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Indicates Response Required