Winter Orientation Program Registration

WINTER ORIENTATION PROGRAM REGISTRATION

Contact and Sponsor information:

Name (required)

Email (required)

Address (required)

Telephone (required)
Cell phone
Name of sponsoring agency (required)

Program fees should be billed to  Sponsor  Participant

Personal and Family information:

Gender  Female  Male
Date of Birth
Post-secondary education

Special interests and/or talents

Spouse's name (if applicable)*

*If your spouse is also going to participate in this Forum program,
he/she must submit a separate registration form.

Will your spouse accompany you on your placement?
 Yes No
Names and ages of children who will accompany you on your
placement (if any)

Will your children attend the Children and Youth Program?
 Yes No

Orientation-related information:

Please describe (where and what) the anticipated overseas
placement, if known

Work or related experience to global cross-cultural ministry

Previous overseas experience (Please indicate country,
assignment, and dates of service.)

What training or orientation have you had in preparation for
cross-cultural and/or overseas assignments? (Please indicate
date, length and location of each training or orientation taken.)

What do you consider to be your most important needs in
preparation for overseas service at this time?

Travel information:

How are you travelling to the Orientation Program (if known*)?

*If you have not made travel arrangements yet, please notify the
Forum as soon as you have arrival and departure information.

Arrival date and time

Departure date and time

Accommodation and Special Needs:

• Accommodation rates are based on double-occupancy.
  If you prefer single-occupancy, and space is available,
  would you pay an additional fee for it?  Yes No
• I would prefer to share a room with
  

Special Dietary and Other Needs:

• I prefer vegetarian entrées only:  Yes No
• Other dietary needs or food allergies (if any)
  
• Other (non-food related) allergies (if any)