Request your visit

Your Information

First Name of Contact:

Last Name of Contact:

Age:

Gender:

Address line 1:

Address line 2:

City

Province

Postal Code:

Supporter Number:

Phone Number:

Email:

Email Confirm:

Travel Information

Country you're visiting:

Departure Date from Canada:

Arrival Date into Country:

Departure Date from Country:

Preferred Visit Date (Mon to Fri):

Alternative Visit Date (Mon to Fri):

Address of accommodations where you will be on requested visit date (please provide at least city):

In Country Phone Number:

Would you like Compassion to arrange transportation for your visit day?

Yes

Compassion Child Information

How many people will be visiting the Compassion child?

Please complete for each child.

Name and number of the child to be visited:

Are you the child’s supporter?

Yes

Additional Visitor Information

Please complete for each visitor.

Full Name:

Age:

Gender:

Supporter Number (if applicable):

Address is the same as requestor

Yes

Additional Details

Additional details/requests you would like us to know about your Visit Request: