EmailMe Form - The Journey | Campus Interest Form

Your Details

Tell us about yourself and your organization...

Institution *

Your Name

First Last

Your Email Address *

Your Role *

In your role, are you authorized to confirm a trip *

Yes

No

Confirm = ability to sign an agreement and executive payment. If your answer is no, please fill out the next set of questions.

Authorized Contact Name

First Last

Authorized Contact Email

Authorized Contact Role

Your Journey

Now tell us what you're thinking about for this trip...

Who is the trip for? *

When do you want to take the trip? *

Break Start Date: *

MM / DD / YYYY

Break End Date: *

MM / DD / YYYY

What kind of trip do you want to take? *

Domestic

International

What is your budget for this trip? *

Would you want an event fundraising page set up for this trip? *

Yes*

No

*nominal fees would apply

How many people do you think will go on this trip?
We will coordinate trips with a minimum of 13 participants and a maximum of 23.

Thank You...
...for taking a few moments to provide us with this information. Please note that by filling out this form, you have not committed to hosting a session of The Journey. You have simply provided us with the necessary information to initiate a follow-up conversation.

Again, if you have any additional questions, please contact Ryan O'Rourke, Executive Director.