Geobound Application Form

Personal Information

Name

First Name

Last Name

Your phone number

Country

(###)

###

####

Email Address

Your present address (Where we may contact you prior to departure.)

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

SS#

Birth Date

YYYY

Birth Place

Country Of Citizanship

Marital Status:

If you are married and have Children, list spouse and children and birthdays

Closest living Relative

First Name

Last Name

Closest living relative's address?

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Closest living relative phone number.

Country

(###)

###

####

Relation to relative.

Are you in good health?

If no, please explain:

Do you have any physical disabilities?

If so, please describe:

Personal Reference

Character Reference

First Name

Last Name

Reference Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Reference Phone

Country

(###)

###

####

Christian Background

Date you accepted Jesus Christ as your personal Savior

YYYY

Date you received the Baptism of the Holy Spirit.

YYYY

What denomination were you raised in?

Select one of the following:

I am a licensed minister

I am a ordained minister

I am both a licensed and ordained minister

Neither

With which Church, denomination or organization?

What is your ministerial qualification or calling (preaching, teaching, worship, witnessing, evangelism, exc.)

List some Christian ministry activities you have been actively involved with in your local church:

Church Name:

Pastors Name:

First Name

Last Name

Church Address:

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Church Phone:

(###)

###

####

Academic Background

Select level of high school completed:

Completed level of highschool

Vocational:

Technical:

Select level of collage completed:

If other, please explain:

Occupational Background

List your primary job skills? (example: typing, electrical, nurse, carpenter, exc.)

List your previous employer company name:

Director / Supervisor

First Name

Last Name

Duties:

Start date of employment

YYYY

End date of employment

YYYY

Currently still employed

Mission Field information

With which ministry will you be working with?

In what counrty?

What is your date of departure?

YYYY

How long do you plan to be there?

What will you be doing?

List languages you speak:

Give a brief detailed overview of any other missions groups you have been involved with or served with as a short or long term missionary; what you have done, with what group, and dates you were there:

What are your goals for the future of your missionary work?

Mailing Information

To what address do you want correspondence sent to on the mission field?

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Financial Information

Name of Bank:

Bank Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Bank Phone

Country

(###)

###

####

Checking account number:

Contact Person: (Person handling mail or finances)

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

What is the estimated budget that you have determined will be required for you to operate on the mission field?

The information given on this application is true and correct to the best of my knowledge.

Yes

By submitting my full name I verify this as my signature.

First Name

Last Name

Todays Date:

YYYY

Cart (0)