SHORT TERM MISSIONS INQUIRY Please complete this form entirely. Please list the trip(s) you would like to join us on: Have you ever been on a mission trip before? Yes No How did you hear about PMImissions and our offered short-term trips? What is the name of your home church? Full Name: First, Middle, Last Gender: Male Female Birth Date: Country of citizenship: USA CAN OTHER If other is selected, please give us your country of citizenship in the special notes section. Email: Address: Please enter your complete mailing address including your zip code Cell Phone Number: Home Phone: What is the best way to reach you? Home Phone Cell Phone Text Email Special note to David and Shonda Tompkins: Please explain the reason you desire to be a part of this mission trip SUBMIT FORM
