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Name: Nickname:

Home Address:

E-mail Address:

Country of birth: Home Phone:

Date of birth:

Marital Status: Single Married Separated Divorced Widow: Widower:

Spouse's Name

Sex:(M/F) Height:(Ft./In.) Weight:(pounds)

Languages spoken/read

What musical instruments do you play well?

Have you any vocal ability(solo,group,choir,etc.)?

Date of last physical exam(dd/mm/yy)

Present Health: GoodFair: Poor:

Do you wear contact lenses? Yes No

If you wear contacts, we recommend that you bring extra solution and a pair of glasses with you.

Do you have any physical handicaps?
Yes No If yes, explain

Presently are you taking medication?
Yes No If yes, explain

Do you use: Tobacco? Yes No Alcoholic Drinks? Yes No Illegal drugs? Yes No

Since nationals view each crusader as a missionary, it is necessary for crusader to comply with missionary standards. Therefore, while in transit to and from the field, and while on the field no tobacco, alcohol, or illegal drugs are permitted.


Business Phone Position


Explain how you feel your skills, hobbies and Professional training can be beneficial on an overseas mission field.

What kind of passport you have:

Do you have a passport? Yes No Passport Number

Issued where Date issued Date expires

Citizenship Former nationality, if any

In case of emergency, notify Name Phone

Address Fax


Church Pastor's Name


Describe church activities(committees etc.)

Do you attend church regularly? Yes No

Do you belong to any other organization? Yes No


Address: Phone

Fax: E-mail:


Course for which you are applying Crusade for which you are applying
Learn to Play the Steelpan(individual/group) Witness crusade(Mission Tour)
Steelpan Manufacturing Work crusade(Mission Tour)
Steelpan Instructors Training Course Professional Services
Tie Dye & Batik  

Telephone: 1-(868)-633-3578 Fax:1-(868)-632-7269