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First visit: enter red fields and as much of the rest as you want.
Return visit: enter red fields and anything you want to update.
Married both interested: complete form together, e.g. John & Jane Doe.

 
Your Name(s)  
Country: currently only USA retreats offered
Email
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Street Address
City/State/Zip
School,Church or Organization
Male/Female
Date of Birth mm/dd/yy
Marital Status
Current Role(s) Professional  Student  Parent
Preferred Phone
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Which is cell Preferred   Alternate  
Text my cell Yes, if needed   No, please 
Time(s) to call 12p- 6p  6p-8p  8p-10p

Which of the following best describes your interest in this retreat?

     

I am exploring missions opportunities one week to two years.

     

I am exploring missions opportunities two years or longer.

     

I am committed to finding a full-time missions placement for two years or longer.

    

I am a missionary willing to serve at the retreat as a missions coach.

  

Other


Which retreat interests you most?

     

Oct 17-19 Pacific Region (Pasadena, California)

     

Nov 14-16 Southeast Region (Atlanta, Georgia) 

     

Apr 24-26 North Central Region (Chicago, Illinois) 

     

May 29-31 Southwest Region (Dallas, Texas) 

     

Jun 26-28 Northeast Region (Philadelphia, Pennsylvania)

    

I want to make a donation to help prospective missionaries attend. After "Submit Form" below you'll see how to donate.

    

I am interested in other retreats. Please contact me when those dates, locations and local hosts are selected.


Which option are you selecting today?

     

I want to register and pay with a credit card. After you click "Submit Form" below you'll see how to pay.

     

I want to register and pay electronically from my checking  account.  After "Submit Form" below you'll see how.

     

I want to register and mail a check with $5 more for manual processing. After "Submit Form" below you'll see how.

    

I understand space is limited. Please contact me later so I may decide and return here to pay.

    

I am applying to be a mission coach at a retreat. Email me to schedule the required phone interview.

    

Keep me updated on future retreats.

Who told you about the retreat? In what ways did you learn about it?


What areas do you have the most passion or experience? (check all that apply)

  Business & Administration Children & Youth
  Computers & Technology Evangelism & Church Planting
  Humanitarian Aid    Media & Communications
  Medical Sports & Coaching   
  Teaching Urban Ministry

If you are registering now please complete the rest of the form below. Otherwise scroll to the bottom and Submit Form.

Driving and open to car pooling with others from my area.

Flying and interested in airport shuttle options.

In small group discussions I'm often quieter than others.

In small group discussions I'm often more expressive than others.

I am willing to bring and use my own sleeping bag/air mattress so more can attend; others can have the beds..

Required: briefly mention previous missions exposures you have such as a short-term missions trip, Perspectives course or other missions training (one exposure is a pre-requisite for the retreat).


 

Optional: enter comments below such as any nickname you prefer on your nametag, friends who may be attending that you would like in your small group, which unreached peoples or areas of the world interest you, etc.


Now please click Submit Form below:

      





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2008 Fall Retreats
Oct 17-19 California
Nov 14-16 Georgia


2009 Spring Retreats
Apr 24-26 Illinois
May 29-31 Texas

Jun 26-28 Pennsylvania

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