Getting to know you...

As a child sponsor, you are at heart extended family to us. You are an "Auntie" or an "Uncle" and we'd love to spend some quality time with you. Whether you've been to Rehema Home before or not, we'd like to make sure we get to know you before you arrive. 

 

Please complete the form below

General Information
Name *
Name
Sex *
Address *
Address
Your Preferred Phone *
Your Preferred Phone
Personal Information
Travel Information & History
Do you have a valid passport? *
Birthdate *
Birthdate
Have you participated in any overseas travel experiences in the past? *
Country, Length of Trip, Reason for Trip (Missions, Business, Pleasure, etc.)
Health & Background Information
Have you ever been convicted of a misdemeanor or felony? *
Emergency Contact Information
Primary Emergency Contact *
Primary Emergency Contact
Secondary Emergency Contact *
Secondary Emergency Contact