Oregon Trails Walk to Emmaus

First Name: Last Name:

Address:

City: ST: Zip Code:

Home Phone: Cell Phone:

Gender: Male Female

Over 18 Years Old: Yes No

Email Address:

Serve on Flight Number: (Flight 26 is in the Summer of 2012)

Flight Type: Girls Boys

Previous Team Experience

Talents & Abilities

I would like to serve in:

Cocoon Background

(A sponsor may only work in the Inn if they feel it will not be a distraction to the Caterpillar)

I would like to serve as a member or lead in the following capiacity:

Lay Director Youth Lay Director Clergy Cha

Speaker Table Leader/Backup Speaker Music Kitchen

Prayer Chapel Agaperations Logistics Coordinator

Recorder Trailer Angel Background Music

Sat Love Team Head Sun Love Team Head

I would like to serve as the team head for:

Special Diet Needs

Special needs, medications or other considerations

I will be sponsoring a Caterpillar

Please be sure to submit your $50.00 per person fee by check or by PayPal.

Scholarships are generally available but MUST be requested in advance.

Payment Method: Check PayPal Scholarship

(PayPal allows for payment via your own PayPal account or by credit card)

Scholarship Amount Requested

Please make all checks payable to OTWTE and mail them to:

Treasurer
P.O. Box 30556
Portland, OR 97294

Please note what the check is in payment of.