Welcome to the Appalachian Impact 2018 Registration Form. The 2018 mission dates are July 1 - July 7, and the total cost will be $550 per person, which includes transportation, room, meals and supplies.
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By completing this application and submitting your non-refundable deposit of $50**, you are reserving a spot for the 2018 trip.

**A $50 non-refundable registration fee is required for each participant. This amount will be applied to the total cost of the trip. Click the link on the information page for online payment, or make a check payable to Grace Chapel with "Appalachia Registration" on the memo line. Mail the check to the address on the website or drop it off during office hours. Your registration is not complete until the deposit is received.
 
Full Name *

 
Full Address *

 
Phone Number *

 
Are you... *


 
Age *

 
What is your home church? *


 
In a few sentences, explain why you would like to participate in Appalachian Impact *

 
Each participant will receive an Appalachian Impact T-shirt. What size would you like? *


 
There will be several different opportunities to serve, requiring various degrees of skill and experience. Please indicate below the areas in which you would be willing to serve.

Please note, this is not a project assignment. It is simply to help the leadership team determine the skills and abilities of those participating.

 
For Michigan based participants, you are required to attend at least two of the three team meetings held on March 18, May 15 and June 24. Are you able to do this?

If your answer is no, a member of the leadership team will contact you to discuss the circumstances that are preventing you from doing so.
     
 
Thank you for registering! Don't forget to submit your $50 deposit online at the Grace Chapel website or by check.

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