Group Application Interested in serving with us? Fill out this form and we’ll be in touch! Group Application Apply for a group to visit PRIMARY CONTACT PERSON INFOFirst Name* Primary ContactLast Name* Primary Contact Last nameEmail* Phone Number* ORGANIZATION INFOOrganization NameName of Organization, School, or Church Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Trip DatesChoice 1* MM slash DD slash YYYY Starting date for choice 1Choice 1 end MM slash DD slash YYYY Ending Date for Choice 1Choice 2* MM slash DD slash YYYY Starting date for choice 2Choice 2 end MM slash DD slash YYYY Ending date for Choice 2Choice 3* MM slash DD slash YYYY Starting date for choice 3Choice 3 end MM slash DD slash YYYY Ending date for choice 3The GroupGroup# of Girls Expected (including leaders)* # of Guys Expected (including leaders)* Age Range of Group (not including leaders)* Total Group Size (including leaders)* The LeadersFor high school groups and college groups with adult supervision, your group needs to have at least one leader of each gender represented in your group (with the exception of adult leaders bringing their own children). For high school and younger groups, we recommend a leader/student ratio of 5 to 1, but that is a guideline, not a requirement.Leader 1 Name Leader 1 Phone # Leader 1 Gender Male Female Leader 2 Name Leader 2 Phone # Leader 2 Gender Male Female Leader 3 Name Leader 3 Phone # Leader 3 Gender Male Female Leader 4 Name Leader 4 Phone # Leader 4 Gender Male Female Leader 5 Name Leader 5 Phone # Leader 5 Gender Male Female Additional ConcernsThese could include physical or mental health issues, dietary requirements, strong allergies, or other similar issues. Our regular dorm space is not handicap-accessable at this time, but accommodations can often be made.ArrivalWe recommend that you arrive between 1:00 PM and 5:00 PM when possible (any time is workable, though). This will give you some time to explore and get used to your surroundings. Most of our visitors find street-side parking. We recommend $15/day parking in a local parking garage for smaller vehicles (experience has proved that anything taller than a mini-van will not fit!). If you are coming in by plane or train, we can arrange for pick up or help your group navigate the CTA’s (Chicago Transit Authority) train and bus system (yet another learning experience to add to your trip!).Estimated Time of Arrival* Means of Transportation* DEPOSIT AND PAYMENTOur current rate for room and board is $50 per person per night. Please, do not send deposit until your dates have been confirmed. Once your dates have been confirmed, please send your deposit right away. We will hold your dates for up to one month after confirmation, awaiting your deposit. If we have not received your deposit by the end of that month, we may schedule another group for those dates and you may need to reschedule. The deposit will be subtracted from your payment. Please plan to make total payment on or before the day of your arrival. Deposits are not refundable. Please make checks payable to: Jesus People USA. Please send checks to: JPUSA Group Missions 920 W. Wilson Ave. Chicago, IL 60640Deposit Amount*Note: The deposit is per group (not per person). February – April (Spring Break): $200 June – August (Summer): $300 Rest of the Year: $100 Questions, Comments, etc.Please feel free to call us @ 331.308.2757 with any additional information or if you have any questions. Δ
