HCM Trip Reservation Request Form:

Name of Team Leader *
Name of Team Leader
Team Leader Phone Number *
Team Leader Phone Number
(i.e. Food Distribution, Generator Costs for Surgical Teams, Mobile Clinic Fees, Building Projects, etc.)


*Team ground fees are due 30 days prior to trip.
*All funds can be sent to PO Box 880808 Boca Raton, FL 33488 or submitted online.
*Please include team name on all checks and forms.
*Team leaders should collect and send team's funds.
*Prior to mailing project funding, please email trips@haitianchristianmission.org the amount being sent so it can be properly recorded.

For further questions, contact us:

By Email:


By Phone:

844-426-1974 ext. 3

By Mail:

Haitian Christian Mission
PO Box 880808
Boca Raton, FL 33488