2006 Application

TORCH APPLICATION FORM ’06 Cost of trip is $1250.
TORCH MISSIONS
7949 Winchester #308
Memphis, TN 38125-2311
Choice TORCH trip Dates June 21-30____ OR July 21 – 30_____
Email address___________________
Name_________________________________ Date of Birth_____________ Age______
Street Address______________________________________________
Home Phone______________________
Cell Phone_____________________________
Social Security Number_______________________
Passport Number_______________________
City Issued_________________________
Date Issued____________________________
Expiration Date_____________________
Are you a Christian? Yes____ No_____
Name of Church you attend_________________________________________________
Address of Church you attend_______________________________________________
Male____ Female____ Adult____ Teen____ Child____ Single____ Married______
If married are husband and wife on the trip together?? Yes_____ No_____
Do you prefer staying with your spouse on the trip? Yes_____ Will Chaperone______
Adults occupation__________________________________________________
Students academic classification & name of school____________________________
Languages you speak__________________________________________________________
Foreign Countries you have visited______________________________________
Are you in good physical condition? Yes_____ No______
Are you taking prescription medication on a regular basis? Yes____ No_____
If yes, List medications and conditions being treated _________________________________________________________
Allergies___________________________________________________
Adult T shirt size Small_____ Medium_____ Large_____ XLarge ______ XXL_____
I have read and accept the conditions listed in the information section of the TORCH Program AND I commit to raising a minimum of $200 over and above the cost of the trip to support the benevolent work of my team.

___________________________ _______________________
Signature Date
IMPORTANT
Everyone traveling must fill out an application
This application is due February 1st & must be accompanied by:
$150 deposit
Spanish Parent consent form, signed and notorized
Copy of your passport
One Passport sized photo
Letter of recommendation for TORCH trip (if it is your first trip)
Essay: Why do you want to participate in this trip