Go on a Mission Trip

Name:__________________________________________________________________
                        First                            Middle                        Last

Name as it appears in the Passport, if different:_________________________________

Passport Number:________________________________________________________

Country Issuing the Passport:_______________Expiration Date:__________________

Departure/Return city (if other than Portland, OR):______________________________

Address:________________________________________________________________

Telephone:___________________eMail:______________________________________

Dietary Restrictions:______________________________________________________

Medical Concerns you want us to know about:_________________________________

To confirm your Reservation and to hold your seat, please return this form to:

            FETCH
            P O Box 91233
            Portland, OR 97291-0233

with a deposit of $100 Payable to FETCH by September 1. Your deposit will be applied towards your ticket. This is done to confirm your going with the travel agent.

Note: The total cost is estimated to be between $2300 and $2500 depending on how many people go on the trip. We require this amount to be paid by December 1. All passports and visas should be obtained by the end of December. If you need help with obtaining passport and visa, please contact Franklin Moses by October 1.