PARTNERSHIP INTERNATIONAL
ABOUT US
2026 LOCATIONS
TRIP PREPARATION
APPLICATIONS & FORMS
CONTACT US
GIVE
ABOUT US
2026 LOCATIONS
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