Team Leaders:
As we look ahead to 2012, we need each new trip to confirm its status for this coming year. Please take a few minutes and fill out the information below to be best of your ability.

If you have any questions, contact Paul Stevens at paul.stevens@lipscomb.edu or 966.2015.

Leadership Information Primary Leader
Name (First and Last):
Classification:	Select One Freshman Sophomore Junior Senior Alumni Faculty Staff Friend of LU
L Number:
E-Mail Address:
Cell Phone:
Supporting Leader
Name (First and Last):
Classification:	Select One Freshman Sophomore Junior Senior Alumni Faculty Staff Friend of LU
L Number:
E-Mail Address:
Cell Phone:
Supporting Leader
Name (First and Last):
Classification:	Select One Freshman Sophomore Junior Senior Alumni Faculty Staff Friend of LU
L Number:
E-Mail Address:
Cell Phone:
General Trip Information
Trip Name:
Location:
Time Frame:	Select One Fall Break 2010 Winter Break 2011 Spring Break 2011 Summer 2011
Type:	Select One Domestic International
Approximate Departure Date:
Approximate Return Date:
Sign-Up Method:	Select One FirstCome/FirstServe Application
Trip Capacity:
Estimated Cost:
Partnership Information Please provide the following information regarding what organization, ministry or church you are partnering with. This information might also serve as an emergency point of contact in location.
Name:
Contact Name:
Contact Phone:
Contact E-Mail:
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