This application is specifically for the Summer trip to Alaska.
Email:
Name:
CPO:
Phone:
Cell Phone:
Date of Birth:
Year at North Park:
1st 2nd 3rd 4th
Do you speak another language? If so, which one(s)?
Emergency Contact:
Emergency Contact Address:
Emergency Contact Phone:
Health Insurance Company:
Policy Number:
Contact Phone:
Do you have a U.S. passport?
Yes No
1. Please comment on any areas of expertise or experience that you have that would be an asset to this trip? 2. Why do you want to go on this trip? 3. What concerns do you have about going on this trip? 4. How and when did you make a commitment to Christ?
