If you are interested in going on this trip please fill out the below information. You may either type in your
information or print the form, fill it out, scan it, and email it to LUOAmissions@liberty.edu by Oct. 26, 2015.
STUDENT CONTACT INFORMATION (LUOA juniors & seniors only)
Full Name:
☐Male ☐Female
Student ID:
Grade level:
Address:
City:
Home Phone: (
State:
)
Email:
-
Zip Code:
Cell Phone: (
)
Date of Birth (MM/DD/YYYY):
/
/
Do you have any skills or talents that would be helpful on the mission trip? ☐Yes ☐No
If yes, please share here.
Have you been on a mission trip before? ☐ Yes ☐ No
If yes, when and where?
Do you speak Spanish? ☐Yes ☐ No
PARENT/GUARDIAN CONTACT INFORMATION
Full Name:
☐Male ☐Female
Relation:
Address:
City:
Home Phone: (
Email:
State:
)
-
Zip Code:
Cell Phone: (
Date of Birth (MM/DD/YYYY):
)
/
I understand that I am responsible for my student during the trip.
/
☐Yes ☐No
Do you have any skills or talents that would be helpful on the mission trip? ☐Yes ☐No
If yes, please share here.
Have you been on a mission trip before? ☐ Yes ☐ No
If yes, when and where?
Do you speak Spanish? ☐Yes ☐ No
My student and I can’t go, but I would be interested in donating money to help cover the cost for
other students and/or supplies for the trip. ☐Yes ☐ No
IMPORTANT INFORMATION:
This trip is designed specifically for LUOA Seniors and their parents. Any senior wishing to come on the
trip must be accompanied by at least one of their parents. The trip dates will be March 12-19, 2016.
Once you send in your completed inquiry form you will be emailed a trip application along with a
background check link. The background check is $22.50 and is non-refundable. Both the application
and background check must be completed for everyone who wishes to join this trip. Please note that
completion of the background check and application does not guarantee you a spot on the trip. Once
we have reviewed both documents we will let you know if you have been accepted.
The trip will cost approximately $2,100 per person, but this is subject to change depending on flight
costs. We would love to take as many people as possible, but we will only have enough room for 25
LUOA Seniors and 25 LUOA parents. It is mandatory that each student has a parent attend the trip
with them. Along with this, we are only able to take students and chaperones who are U.S. or
Canadian citizens.
All students who wish to attend the Guatemala trip must not be any more than 4 weeks behind in
their coursework and must have at least a C or better in all courses.
Applications will be considered for approval in the order that they are received. Be sure to fill out your
application and send it in as soon as possible. Please do not make any payments until your application
and background check have been approved. Lastly, please note that in order to travel internationally
you will need a valid passport through October 1, 2016. Please feel free to email any questions to
LUOAmissions@liberty.edu.