Full Name
              
                * 
              
             
          
                First, Middle, and Last Name, please.
                
                  
                    First Name 
                   
                
                
                  
                    Last Name 
                   
                
               
            
            
            
            
            
            
        
          
          
            
            
            
            
            
              
                
            
              Email
              
                * 
              
             
          
                
                
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Phone Number
              
                * 
              
             
          
                
                
                
                  
                    (###) 
                   
                
                
                  
                    ### 
                   
                
                
                  
                    #### 
                   
                
               
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Home Address
              
                * 
              
             
          
                
                
                  
                    Address 1 
                   
                
                
                  
                    Address 2 
                   
                
                
                  
                    City 
                   
                
                
                  
                    State/Province 
                   
                
                
                  
                    Zip/Postal Code 
                   
                
                
                  
                    Country 
                   
                
               
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Date of Birth
              
                * 
              
             
          
                
                
                  
                    MM 
                   
                
                
                  
                    DD 
                   
                
                
                  
                    YYYY 
                   
                
               
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
              
                
            
              Age
              
                * 
              
             
          
                
                
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Gender
              
                * 
              
             
          
                
                
                
                  
                    Male 
                  
                    Female 
                  
                   
              
            
            
            
            
            
            
            
        
          
          
            
            
            
              
                
            
              Passport Number
              
                * 
              
             
          
                
                
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Expiration Date
              
                * 
              
             
          
                
                
                  
                    MM 
                   
                
                
                  
                    DD 
                   
                
                
                  
                    YYYY 
                   
                
               
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Country of Issue / Citizenship
              
                * 
              
             
          
                
                
                
                  
                    United States 
                  
                    Afghanistan 
                  
                    Albania 
                  
                    Algeria 
                  
                    Andorra 
                  
                    Angola 
                  
                    Antigua and Barbuda 
                  
                    Argentina 
                  
                    Armenia 
                  
                    Australia 
                  
                    Austria 
                  
                    Azerbaijan 
                  
                    The Bahamas 
                  
                    Bahrain 
                  
                    Bangladesh 
                  
                    Barbados 
                  
                    Belarus 
                  
                    Belgium 
                  
                    Belize 
                  
                    Benin 
                  
                    Bhutan 
                  
                    Bolivia 
                  
                    Bosnia and Herzegovina 
                  
                    Botswana 
                  
                    Brazil 
                  
                    Brunei 
                  
                    Bulgaria 
                  
                    Burkina Faso 
                  
                    Burundi 
                  
                    Cabo Verde 
                  
                    Cambodia 
                  
                    Cameroon 
                  
                    Canada 
                  
                    Central African Republic 
                  
                    Chad 
                  
                    Chile 
                  
                    China 
                  
                    Colombia 
                  
                    Comoros 
                  
                    Congo, Democratic Republic of the 
                  
                    Congo, Republic of the 
                  
                    Costa Rica 
                  
                    Côte d’Ivoire 
                  
                    Croatia 
                  
                    Cuba 
                  
                    Cyprus 
                  
                    Czech Republic 
                  
                    Denmark 
                  
                    Djibouti 
                  
                    Dominica 
                  
                    Dominican Republic 
                  
                    East Timor (Timor-Leste) 
                  
                    Ecuador 
                  
                    Egypt 
                  
                    El Salvador 
                  
                    Equatorial Guinea 
                  
                    Eritrea 
                  
                    Estonia 
                  
                    Eswatini 
                  
                    Ethiopia 
                  
                    Fiji 
                  
                    Finland 
                  
                    France 
                  
                    Gabon 
                  
                    The Gambia 
                  
                    Georgia 
                  
                    Germany 
                  
                    Ghana 
                  
                    Greece 
                  
                    Grenada 
                  
                    Guatemala 
                  
                    Guinea 
                  
                    Guinea-Bissau 
                  
                    Guyana 
                  
                    Haiti 
                  
                    Honduras 
                  
                    Hungary 
                  
                    Iceland 
                  
                    India 
                  
                    Indonesia 
                  
                    Iran 
                  
                    Iraq 
                  
                    Ireland 
                  
                    Israel 
                  
                    Italy 
                  
                    Jamaica 
                  
                    Japan 
                  
                    Jordan 
                  
                    Kazakhstan 
                  
                    Kenya 
                  
                    Kiribati 
                  
                    Korea, North 
                  
                    Korea, South 
                  
                    Kosovo 
                  
                    Kuwait 
                  
                    Kyrgyzstan 
                  
                    Laos 
                  
                    Latvia 
                  
                    Lebanon 
                  
                    Lesotho 
                  
                    Liberia 
                  
                    Libya 
                  
                    Liechtenstein 
                  
                    Lithuania 
                  
                    Luxembourg 
                  
                    Madagascar 
                  
                    Malawi 
                  
                    Malaysia 
                  
                    Maldives 
                  
                    Mali 
                  
                    Malta 
                  
                    Marshall Islands 
                  
                    Mauritania 
                  
                    Mauritius 
                  
                    Mexico 
                  
                    Micronesia, Federated States of 
                  
                    Moldova 
                  
                    Monaco 
                  
                    Mongolia 
                  
                    Montenegro 
                  
                    Morocco 
                  
                    Mozambique 
                  
                    Myanmar (Burma) 
                  
                    Namibia 
                  
                    Nauru 
                  
                    Nepal 
                  
                    Netherlands 
                  
                    New Zealand 
                  
                    Nicaragua 
                  
                    Niger 
                  
                    Nigeria 
                  
                    North Macedonia 
                  
                    Norway 
                  
                    Oman 
                  
                    Pakistan 
                  
                    Palau 
                  
                    Panama 
                  
                    Papua New Guinea 
                  
                    Paraguay 
                  
                    Peru 
                  
                    Philippines 
                  
                    Poland 
                  
                    Portugal 
                  
                    Qatar 
                  
                    Romania 
                  
                    Russia 
                  
                    Rwanda 
                  
                    Saint Kitts and Nevis 
                  
                    Saint Lucia 
                  
                    Saint Vincent and the Grenadines 
                  
                    Samoa 
                  
                    San Marino 
                  
                    Sao Tome and Principe 
                  
                    Saudi Arabia 
                  
                    Senegal 
                  
                    Serbia 
                  
                    Seychelles 
                  
                    Sierra Leone 
                  
                    Singapore 
                  
                    Slovakia 
                  
                    Slovenia 
                  
                    Solomon Islands 
                  
                    Somalia 
                  
                    South Africa 
                  
                    Spain 
                  
                    Sri Lanka 
                  
                    Sudan 
                  
                    Sudan, South 
                  
                    Suriname 
                  
                    Sweden 
                  
                    Switzerland 
                  
                    Syria 
                  
                    Taiwan 
                  
                    Tajikistan 
                  
                    Tanzania 
                  
                    Thailand 
                  
                    Togo 
                  
                    Tonga 
                  
                    Trinidad and Tobago 
                  
                    Tunisia 
                  
                    Turkey 
                  
                    Turkmenistan 
                  
                    Tuvalu 
                  
                    Uganda 
                  
                    Ukraine 
                  
                    United Arab Emirates 
                  
                    United Kingdom 
                  
                    Uruguay 
                  
                    Uzbekistan 
                  
                    Vanuatu 
                  
                    Vatican City 
                  
                    Venezuela 
                  
                    Vietnam 
                  
                    Yemen 
                  
                    Zambia 
                  
                    Zimbabwe 
                  
                   
              
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Are you married?
              
                * 
              
             
          
                
                
                
                
                
                
               
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              If married, will your spouse be joining you on this  trip?
              
             
          
                
                
                
                
                
                
               
            
            
            
            
            
            
            
            
        
          
          
            
            
            
              
                
            
              Spouses Full Name (if accompanying you on this trip)
              
             
          
                
                
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
              
                
            
              How did you hear about LOL Ministry?
              
                * 
              
             
          
                
                
              
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
              
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Phone
              
                * 
              
             
          
                
                
                  
                    
                      Country 
                     
                  
                
                
                  
                    (###) 
                   
                
                
                  
                    ### 
                   
                
                
                  
                    #### 
                   
                
               
            
            
        
          
          
            
            
            
              
                
            
              Email Address
              
                * 
              
             
          
                
                
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
              
                
            
              Relationship to your contact?
              
                * 
              
             
          
                
                
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
              
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Phone
              
                * 
              
             
          
                
                
                  
                    
                      Country 
                     
                  
                
                
                  
                    (###) 
                   
                
                
                  
                    ### 
                   
                
                
                  
                    #### 
                   
                
               
            
            
        
          
          
            
            
            
              
                
            
              Email Address
              
                * 
              
             
          
                
                
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
              
                
            
              Relationship to your contact?
              
                * 
              
             
          
                
                
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
              
                
            
              Group, Church, or Organization name
              
             
          
                
                
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Location
              
             
          
                
                
                  
                    Address 1 
                   
                
                
                  
                    Address 2 
                   
                
                
                  
                    City 
                   
                
                
                  
                    State/Province 
                   
                
                
                  
                    Zip/Postal Code 
                   
                
                
                  
                    Country 
                   
                
               
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Phone
              
             
          
                
                
                
                  
                    (###) 
                   
                
                
                  
                    ### 
                   
                
                
                  
                    #### 
                   
                
               
            
            
        
          
          
            
            
            
              
                
            
              What kind of group/organization are you?
              
             
          
                
                
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
              
                
            
              If a church, list your denomination
              
             
          
                
                
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Has a representative from LOL ever visited your church or organization?
              
             
          
                
                
                
                  
                    Yes 
                  
                    No 
                  
                   
              
            
            
            
            
            
            
            
        
          
          
            
            
            
            
              
                
            
              What is your primary reason for participating in a short-term team trip to Laugh Out Loud?
              
                * 
              
             
          
                
                
              
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Requested start date for your trip?
              
                * 
              
             
          
                
                
                  
                    MM 
                   
                
                
                  
                    DD 
                   
                
                
                  
                    YYYY 
                   
                
               
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Are your dates flexible?
              
             
          
                
                
                
                  
                    Yes 
                  
                    No 
                  
                   
              
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
              
                
            
              Second choice of start date?
              
             
          
                
                
                  
                    MM 
                   
                
                
                  
                    DD 
                   
                
                
                  
                    YYYY 
                   
                
               
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
              
                
            
              Preferred number of days doing construction?
              
             
          
                
                
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
              
                
            
              Preferred number of days doing ministry, VBS, Summer Camp?
              
             
          
                
                
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
              
                
            
              Preferred number of free days?
              
             
          
                
                
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
              
                
            
              Total number of participants on your team (including leaders)
              
                * 
              
             
          
                
                
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
              
                
            
              Age range of team members?
              
                * 
              
             
          
                
                
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
              
                
            
              Estimated number of male participants (including leader)
              
                * 
              
             
          
                
                
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
              
                
            
              Estimated number of female participants (including leader)
              
                * 
              
             
          
                
                
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
              
                
            
              Number of male team leaders
              
                * 
              
             
          
                
                
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
              
                
            
              Number of female team leaders
              
                * 
              
             
          
                
                
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
              
                
            
              Please list the names of the leaders
              
             
          
                IMPORTANT: If there are both male and female participants in your group, you must have both a male and female leader.
                
               
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
            
            
            
              
                
            
              Total number of married couples
              
                * 
              
             
          
                
                
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
              
                
            
              Please list the names of married couples
              
             
          
                
                
              
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
              
                
            
              Please list any special needs for any member of  your group that LOL should be made aware of
              
             
          
                i.e specific allergies, food intolerances, illnesses, handicaps, etc) 
                
               
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
            
        
          
          
            
            
            
            
              
                
            
              What do you hope to gain for your team during your time at Laugh Out Loud?
              
                *