Grab your passports and go on a mission trip with us!

Join us on a transformative mission trip to make a difference in the lives of orphans and widows. Together, we'll not only offer essential support but also share the uplifting message of hope through the spreading of the gospel. Your presence can bring light to those in need, take part in local outreaches, and create genuine friendships that will last a lifetime.

- July 2-12, 2024

Trip Date: July 2nd through July 12th

Investment: $3400 / $3600

Your participation is not just a commitment to others; it's an opportunity for personal growth and a chance to be part of something truly meaningful.

Together, we will collaboratively work towards creating an incredible impact and fostering hope in the communities and villages of Rwanda.

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Intrested in the trip? Want more info before applying? Fill out this form!

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Name *

First

Last

Date / Time *

Email *

Phone *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Have you been on a mission trip before (with anyone, anywhere)? *

Previous Mission/Travel Experience *

If you have been on a mission trip before or have traveled abroad, please describe your previous experience.

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Trip Interest Info Form

Rwanda Trip Application Form

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Name *

First

Middle

Last

Phone *

Email *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Passport #

Expiration Date

Citizenship Country *

Date Of Birth (dd/mm/yyyy) *

Male/Female *

Male
Female

Marital Status

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If married, Write Spouse's name

What's the name of the church you attend?

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REFERENCES

REFERENCE 1 - Name and Lastname *

Please list two references, other than family, who can be contacted on your behalf.

REFERENCE 1 - Phone *

REFERENCE 1 - Relationship *

REFERENCE 1 - Email *

REFERENCE 2 - Name and Lastname *

Please list two references, other than family, who can be contacted on your behalf.

REFERENCE 2 - Phone *

REFERENCE 2 - Relationship *

REFERENCE 2 - Email *

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GENERAL HEALTH

MEDICAL HISTORY

Have you ever had any of the following?

Asthma
Blood Disorder
Cancer
Diabetes
Fainting Spells
Heart Disease
Hepatitis
High Blood Pressure
Kidney Disease
Lung Disease
Migraine Headache
Recurrent Infections
Rheumatic Fever
Seizure

Please choose as many as you need to indicate.

Other, please explain

Medications

List all medications (both prescriptions and over-the-counter) you are currently taking ( name and dosage).

Allergies

Specify any allergies to medications, foods, insects, etc and describe reactions.

Diet

Explain any special dietary needs

Additional medical information your team leader should be aware of

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MEDICAL INSURANCE INFORMATION

Health Insurance Company Name *

Group # *

Subscriber Name *

Policy # *

Primary Doctor's name *

Phone *

Date / Time

LEGAL WAIVER SIGNATURE: I am aware that all positions are voluntary, without financial remuneration. I agree to abide by all present and subsequent issued rules of Apple Of His Eye Charity . I clearly understand that raising all expenses, including travel to and from the designated location, will be my responsibility. I further agree that AHEC has the right to discontinue my ministry through AHEC at any time at its sole discretion. I recognize that participation on a trip of this nature may be hazardous or dangerous. Therefore, I am, for myself, my heirs, executor and/or administrator, releasing and forever discharging AHEC and all its officers, agents, servants and employees, acting officially or otherwise, from any and all reason of injury, damage (including property damage to any of my belongings), loss or death which may occur from any cause including, but not limited to, any accident and/or occurrence while participating individually or with others while with this mission agency and/or on this mission trip. Furthermore, I realize all contributions to AHEC are tax-deductible. Contributions are non refundable in the event that the applicant chooses not to participate in the program. The financial disbursement of these funds is at the discretion of AHEC. Funds given in excess of the individual’s program cost cannot be returned but will be used to further the ministries of AHEC. I give Apple Of His Eye Charity the right to use my picture/video, voice and/or testimony in any form of promotional advertising materials. My signature (and signature of my parent/ legal guardian if I am under the age of 18) signifies authorization. The information I have given Apple Of His Eye Charity is accurate and true to the best of my knowledge. My signature (and signature of my parent/legal guardian if applicant is a minor) signifies authorization. *

Clear Signature

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Trip Application

PAST MISSION TRIPS 2024

Trip Date: March 17-29, 2024

Investment: $4000

Interested? Click the button below to complete the "India Trip Interest" form!

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India Trip Interest Form

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Name *

First

Last

Date / Time *

Email *

Phone *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Have you been on a mission trip before (with anyone, anywhere)? *

Previous Mission/Travel Experience *

If you have been on a mission trip before or have traveled abroad, please describe your previous experience.

Comment or Message

India Trip Intrest form for future trips

Experience Missions

Grab your passports and go on a mission trip with us!

- July 2-12, 2024

PAST MISSION TRIPS 2024

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Experience Missions

Grab your passports and go on a mission trip with us!

- July 2-12, 2024

Intrested in the trip? Want more info before applying? Fill out this form!

Rwanda Trip Application Form

REFERENCES

GENERAL HEALTH

MEDICAL INSURANCE INFORMATION

PAST MISSION TRIPS 2024

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