Wednesday, January 17, 2007

2007 Application

2007 Application
TORCH APPLICATION FORM ’07
Memphis - July 20-31
Others July 19-31
Cost of trip is $1325.
TORCH MISSIONS
124 Spyglass Ct
O’Fallon, IL 62269
Email address___________________Name_________________________________
Date of Birth_____________ Age______
Street Address______________________________________________
Home Phone______________________
Cell Phone_____________________________
Social Security Number_______________________
PassportNumber_______________________
City Issued_________________________Date Issued____________________________
Expiration Date_____________________
Are you a Christian? Yes____ No_____
Name of Church you
Address of Church you attend_______________________________________________
Male____ Female____ Adult____ Teen____ Child____ Single____ Married______
If married are husband and wife on the trip together?? Yes_____ No_____
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 15 & 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