Haiti Relief

DONATE
Donations can be sent to:
        Youth with a Mission/Haiti
        P O Box 236
        Akron, PA 17501
OR go to YWAM Donations and donate online.

GO TO HAITI
If you are interested in going to Haiti, please fill out the application below and submit it. We will be planning a couple trips within the next few months.

HAITI RELIEF TRIP APPLICATION
We are sending a team the first week of every month, Saturday to Saturday. The deadline to submit your application is a month before the date you want to go. The exact amount has not been established yet. It will be approximately $700- $900 and will include your flight, transportation to and from the airports and your stay in Haiti. Please fill the following application and submit it. Husbands and wives MUST fill out separate forms. After you have been approved to go, a $100 non-refundable deposit is due.

Full Name
Gender    Birth Date    Age  
Street Address
City    State    Zip 
Home Phone    Cell Phone
Email

PASSPORT
Do you have a passport?   
Name as it appears on your passport
Passport Number    Expiration date

EMERGENCY CONTACT
Name     Relationship
Street Address  
City    State    Zip 
Home Phone    Cell Phone
Work Phone    Email
2nd Contact    Phone

GENERAL INFORMATION
Have you ever been on a mission trip before?  
Where?
Do you have any health issues and if so, what are they?
Do you currently have funds to pay for the trip?   
We are filtering our teams based on the needs of Haiti and the skills that are required for each particular trip. We want to honor Haiti and their requests. What special skills do you have that can be useful in Haiti?
Do you have any particular ministry skills and if so, what are they?

Which month(s) do you want to go?
Where do you attend church?
Who is your Pastor?
Pastor’s  Phone    Email

If you have a group and would like to organize your own trip to Haiti, please contact relief@ywamhaiti.org.