Building Homes Building Hope
Journey of Hope

Name: ___________________________________

Address: _________________________________________________________

Home Phone#: _______________    

Cell#: _______________   

Fax#__________________________    

E-mail: _________________________________

**Passport#: ___________________________________

EMERGENCY CONTACT INFORMATION:

Name: ___________________________________

Address: _____________________________________

Best Contact#: ________________________________

Relatiosnship to you: ____________________________

* Applications will be processed upon receipt of a $100.00 non-refundable application fee. This amount will be credited towards the cost of the trip.

** A passport is required for travel to the Dominican Republis. Applicatiosn can be picked up at your local post office. BHBH does require a copy of your passport to be on file prior to departure.

Please answer the following questions. All answer will be kept confidential. Please be thoughtful and honest.

1. What is your motivation for wanting to participate in this trip?

2. Have you ever lived in, worked in, or traveled to another country? Please explain.

3. Are you currently volunteering locally? If yes, with which organization? If not, why not?

4. Do you have any specific skills/talents you would like to share on this trip? If so, please tell us about them.

5. What concerns might you have about traveling to a developing country?

6. What else would you like to share about yourself?

Signature: ____________________________________

adultapp rev. 9.16.08