Build a Customized Short-Term Mission Trip for Your Church

This form is for GROUPS from churches in the USA only. Individuals please refer to our Short-Term Options.

Complete these catagories, click SUBMIT at the bottom of the form and someone from our office will contact you.

Church Name:

Church Address:

City:

State:

Zip:

Country:

Church Phone:

Church Web Site:

Your Name:

Your Address:

City:

State:

Zip:

Country:

Your Daytime Phone:

Your E-mail:

Your role in the church:

Time of Year:
Use Ctrl + click for multiple options

How many people?

Age group:

Trip duration:

Location and approximate cost for a 10 day trip. Airfare, passport and visa costs are extra. Please choose all that apply or type in your countries of interest.
$200-$300:		OM Ship DOULOS OM Ship LOGOS HOPE
$300-$400:		Central America Moldova Poland Switzerland
$400-$500:		Albania Belgium Czech Republic Hungary India South Africa South America
$500-$750:		Bosnia Canada Central Asia East Asia Eastern Europe France Iceland Nepal New Zealand Spain
$750-$1000:		Australia England (UK) North Africa Ukraine Russia Middle East
		No preference
Other:		Please state other country preferences here.

Possible Ministries: Use Ctrl + click for multiple options
Other:		Please state other ministry preferences here.

Would you like to have an OM USA staff person accompany your team?
Yes No Possibly

Would you like OM to provide short-term training for your church before your trip?
Yes No Possibly

Has your church sent a short-term team with OM before?
Yes When?
Where?
No

Are you interested in an ongoing partnership with this field?
Yes No Possibly

Comments/Questions:

Disclaimer: We will do our best to accomodate your preferences. If we are unable to meet your criteria, we will communicate with you to find an acceptable option.

Please submit this survey by clicking SUBMIT FORM below. Thank you for your interest,

If you do not hear from us within 3 days of submitting this form, please contact Steve Parker at:
1-770-692-5147

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