Short-term Teams Question Title 1. Full Name OK Question Title 2. Email address OK Question Title 3. Telephone number (###-###-####) OK Question Title 4. Home address OK Question Title 5. City OK Question Title 6. State OK Question Title 7. Country OK Question Title 8. Zip code OK Question Title 9. Birth date (mm/dd/yyyy) OK Question Title 10. Age OK Question Title 11. Gender OK Question Title 12. Passport Number OK Question Title 13. Expiration Date OK Question Title 14. Are you a US Citizen? Yes No Other Other (please specify) OK Question Title 15. Marital Status: OK Question Title 16. If married, is your spouse accompanying you on this trip? Yes No OK Question Title 17. Spouse's name (IF accompanying you on this trip) OK Question Title 18. How did you hear about LOL Ministry? OK Question Title 19. Emergency Contact #1 OK Question Title 20. Telephone number (###-###-####) OK Question Title 21. Email address OK Question Title 22. Relationship OK Question Title 23. Emergency Contact #2 OK Question Title 24. Telephone number (###-###-####) OK Question Title 25. Email address OK Question Title 26. Relationship OK Question Title 27. Church name OK Question Title 28. Address OK Question Title 29. Telephone number (###-###-####) OK Question Title 30. Denomination OK Question Title 31. Has a representative from LOL ever visited your church? Yes No Other Other (please specify) OK Question Title 32. What is your primary reason for participating in a short-term mission trip? OK Question Title 33. Requested dates for your trip: OK Question Title 34. Are your dates flexible? Yes No OK Question Title 35. If yes, how flexible are they? OK Question Title 36. (Optional) 2nd choice of dates: OK Question Title 37. Preferred # of days doing construction: OK Question Title 38. Preferred # of days doing ministry: OK Question Title 39. What kind of group/organization are you? OK Question Title 40. Total # of members in your group (including leaders): OK Question Title 41. Age range of members: OK Question Title 42. Total # of male participants (excluding leader): OK Question Title 43. Total # of female participants (excluding leader) OK Question Title 44. Total # of male leaders: OK Question Title 45. Total # of female leaders: OK Question Title 46. Please list the names of the leaders (IMPORTANT: if there are both male and female participants in your group, you must have both male and female leaders.) OK Question Title 47. Total # of married couples: OK Question Title 48. Please provide the names of each married couple: OK Question Title 49. Please list any special needs (i.e. specific allergies to foods/plants/etc..illness, handicaps, etc.) for any member of your group that LOL should be aware of: OK Question Title 50. What do you hope to gain for your team during your time at LOL? OK DONE