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A form for HCP team members to complete as part of signing up to serve with a team
NOTE:
A $250 non-refundable deposit along with your application will secure your spot on the team of your choice. For more information, please go to https://www.hondurascompassion.org/teams/general-team-info/
Name
*
As it appears on your passport
First
Last
Date of Birth
*
MM
MM
1
2
3
4
5
6
7
8
9
10
11
12
DD
DD
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
YYYY
YYYY
2026
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Phone Number
*
Email
*
Citizen of:
*
USA
Canada
You must have a passport valid at least 6 months from your trip date. If your passport was issued by a country other than the US, please verify any entry requirements before traveling.
Passport Number
*
Passport Expiration Date
*
MM slash DD slash YYYY
Known Traveler Number (if applicable)
Enter your KTN here if you have one. This will give you access to TSA Pre-Check lines on domestic legs.
Employer
Many employers offer a ‘Double the Donation’ Program where they will match their employee's donations to a 501(c)3 nonprofit organization up to a certain amount. Some companies even go as far as to match the donations of their spouse! The expenses of your trip to HCP are considered donations and may qualify to be matched! When you provide us with your employer information, our Advancement Team will do all the work of finding out what your employer’s program allows then gets you only the information you need to make your donation go further. This has the potential to have a huge impact on our ability to serve the people of Honduras, thank you for your partnership with us!
Spouse Employer
Which Team Are You Applying For?
*
SELECT YOUR TEAM BELOW
Chesapeake Cares Food Pantry Team - May 44-8, 2025
June Family Team - June 15-19, 2025
Church at Grace Point #1 July 15-22, 2025
Church at Grace Point #2 July 22-29, 2025
Bob's Community Service August 11-16, 2025
Church at Grace Poiny #3 Oct 5-11, 2025
Word Sowers - Oct 19 -26, 2025
Largo Community Church - Nov 1-8, 2025
Westchase Rotary - Nov 10-16 2025
Carroll Creek Rotary - Nov 16-20 2025
FishHawk Riverview Rotary Jan 13-20 2026
Faithful Doers #1 Jan 25-31 2026
Faithful Doers #2 Jan 31 - Feb 7 2026
Sickle Women's Team Feb 9-13 2026
Lakeland Rotary March 14- 21, 2026
T-Shirt Size
*
Small
Medium
Large
X-Large
XX-Large
3X-Large
Youth Large
Youth Medium
Do you Speak Spanish?
*
Yes
No
Allergies - Please list (Mark NA if none)
*
Food Restrictions
Please share any food restrictions and our staff will do their best to accommodate your needs
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