MS Delta Initial Planning

Trip Information
Trip Date Requested*
MM slash DD slash YYYY
Estimate the number of team members / spots you would like to reserve
Male*
Female*
The Jonestown Hope Center has beds for 40 participants.
Team Leader & Organization Information
Name of Church or Group Represented*
Team Leaders Name*
First Last
Team Leaders Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Team Leader Work Phone
Team Leader Cell Phone*
Team Leader Email*
Is the organization contact different than the team leader?*
- Yes
- No
Organization Contact Person*
First Last
Contact Person Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Contact Person Work Phone*
Contact Person Cell Phone*
Contact Person Email*
Areas of service interest*
List the areas you expect your team may be able to serve based on the anticipated skills and abilities of your team members: Medical, Construction, Mechanical, Teaching, Sports, Computer-Business, Business management, Agriculture, and any other areas.

Trip Information