Servant Journey Survey
Date:
Name of Church:
Mailing address:
City:
Zip:
Phone:
Adult Coordinator Name:
Phone:
E-Mail:
Youth Coordinator Name:
Phone:
E-Mail:
Mission Trip History
Please go back about five years with history of trips.
TRIP 1
Trip to:
Date:
Coordinating Organization:
Nature of work done at this location:
Ages of Participants: From
To
Would you recommend this trip to others:
TRIP 2
Trip to:
Date:
Coordinating Organization:
Nature of work done at this location:
Ages of Participants: From
To
Would you recommend this trip to others:
TRIP 3
Trip to:
Date:
Coordinating Organization:
Nature of work done at this location:
Ages of Participants: From
To
Would you recommend this trip to others:
TRIP 4
Trip to:
Date:
Coordinating Organization:
Nature of work done at this location:
Ages of Participants: From
To
Would you recommend this trip to others:
TRIP 5
Trip to:
Date:
Coordinating Organization:
Nature of work done at this location:
Ages of Participants: From
To
Would you recommend this trip to others:
Would your church be willing to open future trips to other churces?:
Other Comments: