Mount Vernon Nazarene University: Life Changing
Bible Trips - Registration Form

Please complete the following fields. You will receive a verification of your registration by email. Priority trip admission will be given to MVNU students. If the trip is full non-MVNU registrants will be put on a first-come, first served waiting list and will be notified.

NOTE:
If you are taking this trip for course credit, you will still need to register for the class at MVNU. Contact us if you have any questions.

Name:
Name(Do not fill this):
Mr. Mrs. Ms. Rev. Dr.
Preferred Name: (If different than above)
Address:
City:
State:
Zip:
Home Phone:
Cell Phone:
Email:
Nationality:
Birthdate: //
Emergency Contact Name:
Relationship:
Phone:


Room Reservations:
Name of Your Roommate (as on passport):


Please Select Course as Appropriate:


Comments/Questions:


 
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