DRM2010 TRIP PAYMENT INFORMATION

$100 due with this application (payable by clicking here)
Santo Domingo, Dominican Republic // June 20-27 (due by April 20th): $1,689
Lima, Peru with Kari Jobe // August 1-9 (due by June 1st): $1,995
Carrefour, Haiti with WME Trip A // October 18-25 (due by September 1st): $1,695
Carrefour, Haiti with WME Trip B // October 21-25 (due by September 1st): $1,565
Christmas in Kurnool, India // December 11-18 (due by October 15th): $2,995

Make all checks payable to: Dominic Russo Ministries*
Dominic Russo Ministries
Attention: <YOUR TRIP>
4840 N. Adams Rd. Suite 418
Rochester, MI 48306

*Tax-deductible receipts are available for donations to you or to your donors. In order for individuals to receive tax credit for donations, contributions must be made to Dominic Russo Ministries, and not to you as an individual.
*Collect checks from your supporters, and send the checks to us with your name on a note, not on the checks. Dominic Russo Ministries will record how much you have raised, and we will send your supporters a tax receipt a the end of the year. None of these monies can be refunded.

FILL OUT THE FOLLOWING INFORMATION IN ORDER TO APPLY FOR ANY OF THE DRM2010 TRIPS:

Trip:
Last Name:
First Name:
Middle Name:
Physical Address (No P.O. Boxes):
Address 2:
City:
State:
Zip Code:
Phone:
E-mail Address:
Date of Birth:
Age:
Height:
Weight:
Marital Status:
Nationality:
Passport Number:
Expiration Date:
Please Honestly Answer The Following Questions:
What is your heart for missions? Why do you want to go on this trip?
Have you ever personally led someone to the Lord? Please explain.
How and when did you become a Christian?
Previous Missions Experience:
Who did you go with?
Where did you go? Year?
Do you speak any foreign languages? How fluent?
Do you play any instruments? How advanced?
Have you ever led worship?