2025 Youth Mission Trip Application

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Mission dates:
Sunday, July 20 - Saturday, July 26

YouthWorks Location:
Benton Harbor, MI

If you are accepted to join us on this YouthWorks mission trip, you will be required to attend a meeting with a parent on Tuesday, June 24 at 6pm in the SJA Terrace.
Parent Name(s) REQUIRED Please fill out this field. Please enter valid data.
Parent Phone Number(s) REQUIRED Please fill out this field. Please enter valid data.
Parent Email Address REQUIRED Please fill out this field. Please enter an email address.
- Number of youth for whom you are registering Please fill out this field.
- Youth 1
  - Youth Name REQUIRED Please fill out this field. Please enter valid data.
  - Have you been on a Mission Trip with Kokomo Catholic Youth in the past? (Priority is given to those who haven't, but does not exclude the possibility of repeat attendance) REQUIRED Yes No Please fill out this field.
  - Youth's Grade in fall 2025 REQUIRED Rising High School Freshman Rising Sophomore Rising Junior Rising Senior Rising College Freshman Please fill out this field.
  - Please note, priority is given to:
    1. Rising Seniors
    2. Rising Juniors
    3. Rising Sophomores
    4. Rising High School Freshmen
    5. Rising College Freshmen
  - Why do you want to go on this mission trip?
  - T-shirt Size Please enter valid data.
  - Youth Phone Please enter valid data.
  - Would you like to be waitlisted if needed? Yes No
- Youth 2
  - Youth Name REQUIRED Please fill out this field. Please enter valid data.
  - Have you been on a Mission Trip with Kokomo Catholic Youth in the past? (Priority is given to those who haven't, but does not exclude the possibility of repeat attendance) REQUIRED Yes No Please fill out this field.
  - Youth's Grade in fall 2025 REQUIRED Rising High School Freshman Rising Sophomore Rising Junior Rising Senior Rising College Freshman Please fill out this field.
  - Please note, priority is given to:
    1. Rising Seniors
    2. Rising Juniors
    3. Rising Sophomores
    4. Rising High School Freshmen
    5. Rising College Freshmen
  - Why do you want to go on this mission trip?
  - T-shirt Size Please enter valid data.
  - Youth Phone Please enter valid data.
  - Would you like to be waitlisted if needed? Yes No
- Youth 3
  - Youth Name REQUIRED Please fill out this field. Please enter valid data.
  - Have you been on a Mission Trip with Kokomo Catholic Youth in the past? (Priority is given to those who haven't, but does not exclude the possibility of repeat attendance) REQUIRED Yes No Please fill out this field.
  - Youth's Grade in fall 2025 REQUIRED Rising High School Freshman Rising Sophomore Rising Junior Rising Senior Rising College Freshman Please fill out this field.
  - Please note, priority is given to:
    1. Rising Seniors
    2. Rising Juniors
    3. Rising Sophomores
    4. Rising High School Freshmen
    5. Rising College Freshmen
  - Why do you want to go on this mission trip?
  - T-shirt Size Please enter valid data.
  - Youth Phone Please enter valid data.
  - Would you like to be waitlisted if needed? Yes No
- Youth 4
  - Youth Name REQUIRED Please fill out this field. Please enter valid data.
  - Have you been on a Mission Trip with Kokomo Catholic Youth in the past? (Priority is given to those who haven't, but does not exclude the possibility of repeat attendance) REQUIRED Yes No Please fill out this field.
  - Youth's Grade in fall 2025 REQUIRED Rising High School Freshman Rising Sophomore Rising Junior Rising Senior Rising College Freshman Please fill out this field.
  - Please note, priority is given to:
    1. Rising Seniors
    2. Rising Juniors
    3. Rising Sophomores
    4. Rising High School Freshmen
    5. Rising College Freshmen
  - Why do you want to go on this mission trip?
  - T-shirt Size Please enter valid data.
  - Youth Phone Please enter valid data.
  - Would you like to be waitlisted if needed? Yes No
- Youth 5
  - Youth Name REQUIRED Please fill out this field. Please enter valid data.
  - Have you been on a Mission Trip with Kokomo Catholic Youth in the past? (Priority is given to those who haven't, but does not exclude the possibility of repeat attendance) REQUIRED Yes No Please fill out this field.
  - Youth's Grade in fall 2025 REQUIRED Rising High School Freshman Rising Sophomore Rising Junior Rising Senior Rising College Freshman Please fill out this field.
  - Please note, priority is given to:
    1. Rising Seniors
    2. Rising Juniors
    3. Rising Sophomores
    4. Rising High School Freshmen
    5. Rising College Freshmen
  - Why do you want to go on this mission trip?
  - T-shirt Size Please enter valid data.
  - Youth Phone Please enter valid data.
  - Would you like to be waitlisted if needed? Yes No
- Youth 6
  - Youth Name REQUIRED Please fill out this field. Please enter valid data.
  - Have you been on a Mission Trip with Kokomo Catholic Youth in the past? (Priority is given to those who haven't, but does not exclude the possibility of repeat attendance) REQUIRED Yes No Please fill out this field.
  - Youth's Grade in fall 2025 REQUIRED Rising High School Freshman Rising Sophomore Rising Junior Rising Senior Rising College Freshman Please fill out this field.
  - Please note, priority is given to:
    1. Rising Seniors
    2. Rising Juniors
    3. Rising Sophomores
    4. Rising High School Freshmen
    5. Rising College Freshmen
  - Why do you want to go on this mission trip?
  - T-shirt Size Please enter valid data.
  - Youth Phone Please enter valid data.
  - Would you like to be waitlisted if needed? Yes No
- Youth 7
  - Youth Name REQUIRED Please fill out this field. Please enter valid data.
  - Have you been on a Mission Trip with Kokomo Catholic Youth in the past? (Priority is given to those who haven't, but does not exclude the possibility of repeat attendance) REQUIRED Yes No Please fill out this field.
  - Youth's Grade in fall 2025 REQUIRED Rising High School Freshman Rising Sophomore Rising Junior Rising Senior Rising College Freshman Please fill out this field.
  - Please note, priority is given to:
    1. Rising Seniors
    2. Rising Juniors
    3. Rising Sophomores
    4. Rising High School Freshmen
    5. Rising College Freshmen
  - Why do you want to go on this mission trip?
  - T-shirt Size Please enter valid data.
  - Youth Phone Please enter valid data.
  - Would you like to be waitlisted if needed? Yes No
- Youth 8
  - Youth Name REQUIRED Please fill out this field. Please enter valid data.
  - Have you been on a Mission Trip with Kokomo Catholic Youth in the past? (Priority is given to those who haven't, but does not exclude the possibility of repeat attendance) REQUIRED Yes No Please fill out this field.
  - Youth's Grade in fall 2025 REQUIRED Rising High School Freshman Rising Sophomore Rising Junior Rising Senior Rising College Freshman Please fill out this field.
  - Please note, priority is given to:
    1. Rising Seniors
    2. Rising Juniors
    3. Rising Sophomores
    4. Rising High School Freshmen
    5. Rising College Freshmen
  - Why do you want to go on this mission trip?
  - T-shirt Size Please enter valid data.
  - Youth Phone Please enter valid data.
  - Would you like to be waitlisted if needed? Yes No
Typically participants / their families are asked to contribute $100 to this mission trip, unless this creates some hardship. The total cost of this trip is expected to be $**** per participant, and the parishes will help to offset this.
Is there a reason you may need financial assistance to help cover $100 per child? (Financial need does not affect priority placement) REQUIRED Yes No Please fill out this field.
By selecting this box, I understand that we will be required to attend a parent-youth meeting on Tuesday, June 24 at 6pm.
I Understand Please select this field.
(For Youth) By submitting this form, I am committed to participating on the trip if I am accepted. Those accepted will be notified by June 2. If I am unable to attend, I will notify Jacob within one week (June 9).
I Understand Please select this field.
(For Parents) I understand that my child is applying to the 2025 YouthWorks Mission Trip with Kokomo Catholic Youth. I understand that the dates of the trip are July 20-July 26, and the expected contribution for each child is $100.
I Understand Please select this field.

Submit

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