Mission Education Trip Application

* denotes required field

Please complete the form on this page. The application does not commit you to go on the trip but gathers information about your interest. FOMM will keep you informed of the plans for the next trip and if you are interested, we will send you notifications of due dates for the next level of commitment.

If preferred, a copy of the application is found here: Mission Education Trip Application

Name and Contact Information

* Name

Names of others joining you on the trip

* Street Address

* City

* State

* ZipCode

* E-mail address

* Cell Phone

Home Phone

Additional Information

* Your purpose for thinking about joining FOMM's Mission Education Trip

* Have you (or the others) traveled internationally before?

Where have you traveled internationally?

Do you (or the others) have any physical limitations or medical issues that would affect your full participation on the trip? Please explain.

* Do you (or the others) have an up-to-date USA passport? (There must be at least 6 valid months left on your passport before entering another country.)

* Write a short paragraph about why you would like to participate in a FOMM Mission Education Trip

* Do you have any requests for what areas of Madagascar that you would like to visit?

* What is the best time of the year for you to participate in this trip?

CAPTCHA