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

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

Occupational/experience

_{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

E-mail

Church Pastor's Name

Address

Describe church activities(committees etc.)

Do you attend church regularly? Yes No

Do you belong to any other organization? Yes No

Name:

Address: Phone

Fax: E-mail:

MISSION PROGRAMME