Mission Trip Payment Processing

Medical Mission Trip Payment Processing

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Contact Information *

Country *

First name *

Last name *

Address 1 *

Address 2

City *

State *

ZIP code *

Email Address *

Phone Number *

Date of Mission Trip *

Month

Day

Year

Attachments

Please upload a copy of your passport and signed waiver.
Files must be less than 10 MB.
Allowed file types: gif jpg jpeg png pdf.

Payment Amount *

$00

I want to cover the processing fees

Card payments: 2.9% + $0.30 • US bank account payments: 0.8% or $5 maximum

Leave this field blank