PARTNERSHIP INTERNATIONAL
ABOUT US
LOCATIONS
2025 TEAMS
TRIP PREPARATION
APPLICATIONS & FORMS
CONTACT US
GIVE
Back
Resurrection Christian School
Destination Church
Evangel Church
Journey Church
Noble Assembly of God
North Central Church
Oasis Church
Oologah Assembly of God
ABOUT US
LOCATIONS
2025 TEAMS
Resurrection Christian School
Destination Church
Evangel Church
Journey Church
Noble Assembly of God
North Central Church
Oasis Church
Oologah Assembly of God
TRIP PREPARATION
APPLICATIONS & FORMS
CONTACT US
GIVE
PARTNERSHIP INTERNATIONAL
-trips that make a difference-
- PERSONAL INFORMATION -
***Please complete ALL sections***
Trip State/City
*
Select one
RICHMOND
DALLAS
KANSAS CITY
NEW YORK CITY
Trip Dates
*
First Name
*
Last Name
*
Full Middle Name
*
Date of Birth
*
MM
DD
YYYY
Gender
*
Select one
Male
Female
Email Address
*
Phone
*
(###)
###
####
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
T-Shirt Size
*
Select one
XS
S
M
L
XL
XXL
XXXL
XXXXL
Church Name
*
Emergency Contact Information
*
First Name
Last Name
24hr Contact Number
*
(###)
###
####
Relationship to trip-goer
*
- HEALTH INFORMATION -
***Please complete ALL sections***
Height
*
Weight
*
Blood Type
*
Select one
O+
O-
A+
A-
B+
B-
AB+
AB-
OTHER
UNKNOWN
Do you have any known allergies?
*
YES
NO
If YES, please list ALL allergies:
Do you have any dietary restrictions or food allergies?
*
YES
NO
If YES, please list ALL dietary restrictions and food allergies:
Are you currently using any medications (prescription or non-prescription)?
*
YES
NO
If YES, please list ALL medications:
Do you have any physical limitations that may prevent participation in rigorous activity?
*
YES
NO
If YES, please elaborate:
Have you had a tetanus shot?
*
YES
NO
If YES, please indicate the date of your most recent shot:
MM
DD
YYYY
Stateside Insurance Coverage
*
We have secondary insurance coverage available for an additional cost of $15.00 per person. Please indicate below whether or not you would like to purchase this coverage
I DO wish to purchase this coverage
I DO NOT wish to purchase this coverage
Additional comments, concerns, notes, or questions:
I verify that all of the information listed above is accurate to the best of my knowledge
*
Thank you!
DOWNLOADABLE STATESIDE TRIP APPLICATION