Personal Data

1. Legal Name (First, Middle, Last)	Preferred Name
2. Spouse Name (First, Middle, Last)	Preferred Name
3. Address

4. Telephone (home, work, cell)	Telephone - Spouse (home, work, cell)
5. Email - Yours	Email - Spouse
6. Citizenship
7. Marital Status
8. Describe your general health
9. Children (names, date of birth, general health, living at home?)

Church Information

10. Home Church Name	Pastor's Name	Denomination
Church Address	Church Phone Number	Church Email Address
11. Do your church leaders agree with your applying for missionary service? Yes No
If no, please explain

Education and Work

12. Education (Name of School, Dates Attended, Major, Degree Completed)

13. Work History (Employer, Dates, Type of work, Reason for leaving)

14. Skills/Proficiency
Computer usage (general)	Beginner Intermediate Advanced No Experience
Microsoft Office Suite	Beginner Intermediate Advanced No Experience
Publishing Software	Beginner Intermediate Advanced No Experience
Accounting Software	Beginner Intermediate Advanced No Experience
Microsoft Outlook	Beginner Intermediate Advanced No Experience
Other	Beginner Intermediate Advanced No Experience

15. Languages (list all languages that you have studied)
	Beginner Intermediate Fluent
	Beginner Intermediate Fluent
	Beginner Intermediate Fluent
	Beginner Intermediate Fluent

16. List any formal Bible classes or nationally recognized Bible study courses you have taken (such as Precept, BSF, Beth Moore, etc.) subject to approval by our Theological Committee. The requirement for long-term (3+ years) missionary service is 16 credit hours or its equivalent in Bible courses. The requirement for short-term (1-3 years) service is a minimum of 3 credit hours. (Course, School/Org., Dates, Credit Hours)
17. Field of Service Preference (check all that apply)
Euro-Asia Asia Pacific Latin America Sub-Saharan Africa	North Africa/Middle East North America Where most needed

18. Length of service desired (check category you are applying for)
Volunteer	Working Visitor	Short-Term (1-2 Years)	Career (3+ Years)

19. Salary (check applicable)
Willing to raise support	Self-supporting	Only Salaried Positions

20. References (include a pastoral/spiritual mentor, employer and friend)
Name/Address	Phone	Email	Relationship

Ministry Information

21. Describe your previous ministry experience and any experiences you have had in leading others to Christ

22. Describe your call to ministry, your motivation in applying for missionary service and the circumstances which have led you to this step

23. Describe how you became a Christian and what that has meant to you

24. Name two significant steps in your walk with Christ

25. How did you hear about HCJB World Radio?

26. What are your Spiritual Gifts, Skills and Interests? (check all that apply)
Administration Encouragement Helping Others Hospitality Special Events	Leadership Praying with People Relationship Building Service Intercession	Wisdom/Insight Working with Children Working with Teens Information Analysis Teaching
Other (Please describe)

27. Are there any circumstances from your past or present that could affect your ability to serve as a minister of Christ? (please explain)

28. Has any employer ever subjected you to disciplinary action, suspended, terminated, or asked you to leave a job or volunteer position on the grounds of any unlawful sexual behavior, or violation of any employer’s sexual misconduct or harassment policy?
Yes No

29. Have you ever been convicted of a criminal offense (misdemeanor or felony, other than minor traffic violations) in a court of law?
Yes No
If yes, please give the nature of the offense, date of conviction, and location of the court

30. Please use the following to tell us anything else you would like us to know or that you think we should take into consideration in evaluating this application

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Personal Data

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Education and Work

Ministry Information

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