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VOI - International Trip Approval Form for Training or Missions

Vision Outreach Trip Information and Approval Form

Following is a brief questionnaire designed to help us help you. Your participation in this effort provides the groundwork for synergy, partnership, and effective communication. Please read the follow information, check all that apply, and give us as many details as possible. Thank you!

Today's Date
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Your Name(*)
Please let us know your name.

Your Email(*)
Please let us know your email address.

Phone or Cell(*)
Put your cell or landline contact number.

Basic Trip Information

Trip City and Country(*)
Please put the city and country of where the mission will be serving.

Trip Dates
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"In Country" Contact Information (or Associate)

Organization's name (if Not VOI)
The name of any affiliated organization that will be working with this trip.

Contact person
Put the name of any in country contact or associate.

Contact Email
Please add the email of the contact.

Contact phone
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Biographical Information

(of Trip Organizer)

Organizer Name(*)
Please list the name of the trip organizer.

Organizer email(*)
Please let us know the email address of the trip organizer.

Phone or Cell(*)
Put your cell or landline contact number.

What type of trip are you planning
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Please give a brief description of your mission and purpose.(*)
Please let us know your mission.

Names of all participants
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Please list the names of each person going on the trip.

Projected cost per individual?
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List of skills or positions needed on this trip?
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Primary Need?
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A brigade is a trip that is primarily organized for prescription glasses, readers, and outside of the eye treatment

Expected Number of Surgeries
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Put an estimated number of surgeries.

Other Information
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