Interest Form | impactmb

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Interest Form

We are excited that your group is interested in coming and joining us! We are excited to help plan your mission trip or allow your group to plan according to your specific needs. Please fill out the form and one of our staff will contact you very soon.

Church Or Group Name

Leader First name

Last name

Position At Church

Leader Phone Number

Church/Group Phone Number

Email Address

Street Address

Street Address Line 2

City

Region/State/Province

Postal / Zip code

Mission Team Information

What Part Of IMPACT ARE YOU INTERESTED IN ?

Use Of Retreat Center

Pre-Programed Missions

Assisted Mission Programming

Date Of Check-In

Last Visit

Date Of Check-Out

No. Of Adults

No. of Girls

No. of Guys

First Time/Returning

First Time

Returning

Additional Information

Thanks for submitting!

P.O. Box 8777, Myrtle Beach, SC 29578

843-626-7069 · info@impactmb.org

© 2024 by Impact Ministry of Myrtle Beach

Registered 501(c)(3). EIN: 27-2059806

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