Caravan Application Fees: $50.00 for a weekend group / $125.00 for week or more This amount is not a deposit and is non-refundable. Note: this form is auto-saved as you fill it out. You can begin filling it out, leave the page, and come back later and your data will still be available. Please do not clear your browser cookies. Church/Organization Details Name Address City State ---AL - ALABAMAAK - ALASKAAS - AMERICAN SAMOAAZ - ARIZONAAR - ARKANSASCA - CALIFORNIACO - COLORADOCT - CONNECTICUTDE - DELAWAREDC - DISTRICT OF COLUMBIAFM - FEDERATED STATES OF MICRONESIAFL - FLORIDAGA - GEORGIAGU - GUAMHI - HAWAIIID - IDAHOIL - ILLINOISIN - INDIANAIA - IOWAKS - KANSASKY - KENTUCKYLA - LOUISIANAME - MAINEMH - MARSHALL ISLANDSMD - MARYLANDMA - MASSACHUSETTSMI - MICHIGANMN - MINNESOTAMS - MISSISSIPPIMO - MISSOURIMT - MONTANANE - NEBRASKANV - NEVADANH - NEW HAMPSHIRENJ - NEW JERSEYNM - NEW MEXICONY - NEW YORKNC - NORTH CAROLINAND - NORTH DAKOTAMP - NORTHERN MARIANA ISLANDSOH - OHIOOK - OKLAHOMAOR - OREGONPW - PALAUPA - PENNSYLVANIAPR - PUERTO RICORI - RHODE ISLANDSC - SOUTH CAROLINASD - SOUTH DAKOTATN - TENNESSEETX - TEXASUT - UTAHVT - VERMONTVI - VIRGIN ISLANDSVA - VIRGINIAWA - WASHINGTONWV - WEST VIRGINIAWI - WISCONSINWY - WYOMINGAE - ARMED FORCES AFRICA/CANADA/EUROPE/MIDDLE EASTAA - ARMED FORCES AMERICA (EXCEPT CANADA)AP - ARMED FORCES PACIFIC Zip Phone Fax Email Pastor/Ministry Leader Name Denomination/Affiliation of Church or Organization Group Leader Details Name Address City State Zip Primary Phone Email Has this leader accompanied a caravan with Mexican Medical Ministries before? Yes No Has this leader had a similar experience? Yes No When and where did this leader go? Each leader will receive a Caravan Leader's Manual. Which format is preferred? Hard Copy CD Email Attachment Trip Details Desired Caravan Dates 1st Choice (MM-DD-YYYY): 2nd Choice (MM-DD-YYYY): Desired Site: Cabo San Lucas Gabriel House La Esperanza Loreto San Filepe San Vicente Tecate Tijuana Mobile Team Other Please describe: Group Details Approximate number in group: Group type: H.S. College Adult Number of people who speak Spanish fluently: Has your group come with Mexican Medical Ministries before? Yes No What in what year(s) and to what site(s) did the group go? How did your group find out about Mexican Medical Ministries (At a conference, online, from a friend, etc. Be as specific as possible)? What specific goals do you wish to accomplish during your time in Mexico? What are your plans to prepare your caravan team for the mission trip?