Registration – IGNIS USA

First Name *

Middle Name

Last Name *

Email Address *

Phone *

Emergency Contact Name (First & Last) *

Emergency Contact Relationship *Your emergency contact's relationship to you.

Emergency Contact Phone *

Sex *We ask for your gender to ensure appropriate sleeping accommodations.

Are you or will you be between the ages of 18-23 for the mission?To attend IGNIS, you must be between the ages of 18 and 23. We are unable to accept participants outside this age range.YesNo

birthdate

Are you or have you attended an institute of higher education?

Which institution of higher education?

Have you completed the Ethics and Integrity in Ministry (EIM) or Virtus training? *(EIM is not required)

T-shirt size *

If there are moments during the Mission that you have to be absent, please let us know now so we can plan accordingly.

Do you have a car and are willing to drive your group to service sites?Yes, and I am willing.No, I don't have a car, and can not drive others to service sites.

Do you speak any foreign languages that could be helpful when visiting homes and service sites?

Do you have any talents that you would like to share during the mission? (e.g., singing, playing guitar, sports, art, etc.)

Please list any special dietary needs or medical concerns that we should be aware of, including animal allergies (some service sites may involve working with animal shelters).

How are you paying dues? *I am paying the full $60 today.I am paying $30 today and $30 later. (You can pay the rest on the Donate page.)I need a scholarship.

Please share as much as you can about why you need a scholarship. *

How many scholarship funds do you need? *$15 - $30$30 - $45$45 - $60

Credit / Debit Card *