This registration form is only intended for those who have been on a J-Team in the past two yearsHave you been on a J-Team since 2019?*YesNo Please go to "New J-Team Registration" Today's Date* MM slash DD slash YYYY Name as on passport* First Middle Last Nickname or Preferred Name Email* PhoneAddress* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PreferencesTrip Preference* Anytime February 4-12, 2023 May 6-14, 2023 August 5-13, 2023 November 4-12, 2023 Preferred area of service* Evangelism/Teaching Medicine Clinical Records Encouragement Building Please Check All* I am responsible for covering my own trip fees as set by TEAMS. The trip fee is $1,250. Contributions will be receipted as being for the work of TEAMS for Medical Missions and credited to my trip account. If there is a surplus after your trip fund is paid, it will be redistributed to other mission needs according to policy. I am responsible for making my own travel arrangements and the cost of purchasing airfare. IRS policies require that once a payment or donation is receipted, non-profit entities such as TEAMS for Medical Missions cannot give refunds While there will be time set aside for sightseeing and recreation, this is primarily a work project involving teaching, evangelism, medical services, and construction. I might need to work in seasonable heat, carry light to moderate loads for short distances, climb steps, be on my feet, or ride in a vehicle on occasionally rough roads. A person who is older or has health concerns should realistically consider the physical demands of such a trip. J-Team members should avoid divisive theological arguments or political discussions. J-Team members should leave the USA and arrive back with the rest of their team unless prior arrangements are made in very special circumstances. During the trip J-Team members should attend all group meetings, prayer and devotional times, and planning sessions. By submitting this Application form I indicate that I have read and understood this form, the J-Team Policy on Refunds, and A Summary of Our Statement of Faith and will work in harmony with them. I am also responsible for information conveyed by other means such as the TEAMS Handbook and all email specific to my trip. Questions, Comments, NotesEmailThis field is for validation purposes and should be left unchanged.