INTERNATIONAL CHRISTIAN MISSIONS
&
VOLUNTEER PLACEMENT CENTER.
www.christianmissions-volunteers.blogspot.com
P.O. BOX 6834-00200 Nairobi Kenya, East Africa
Email: ichristianmissions@yahoo.com / sphinehas@yahoo.com
Telephone: 254-727-241025
APPLICATION FORM
1. Name: -----------------------------------------------------------------------------------------
2. Address: --------------------------------------------------------------------------------------
-------------------------------------------------------------------------------------
2.1 Telephone: Office________________________House__________________
Mobil__________________________________________________
2.2 Email:___________________________________________________________
2.3 Fax _____________________________________________________________
2.4 Physical Address __________________________________________________
__________________________________________________________________________________________________________________________________________
3. Sex: Male Female
4. Marital Status: Married Single Divorced Separated
5. Date of Birth: D. ___ M. ___ Y._____
6. Your Profession / Calling: _____________________________________________
7. Church Affiliation: ___________________________________________________
8. Citizen: _____________________________________________________________
9. Country of Residence: _________________________________________________
10. Category of Placement Applying for: ____________________________________
11. Category of Volunteer Applying for: ____________________________________
12. Duration of Placement / Volunteer Applying for: (As per either No.9 or 10)
1-Week 2-Weeks 3-Weeks 1-Month 2-Month 3-Month
Other___________________
13. Month and Dates you wish to Minister / Volunteer: (As per No.9 or 10)
_________________________
14. Your Pastor’s Bishop’s Leader’s Name: __________________________
14.1. Address: _______________________________________________________
14.2. Telephone: Office: _________________ Mobile: _________________
House: __________________
14.3. Fax: ________________________ 14.4. Email: ______________________
14.5 Recommendation Letter from either of No. 14. (300 words)
15. Have you been to Kenya or any of the East and Central Africa countries?
Yes No
If Yes, which city and country?_______________________________
16. A short history about yourself (200 words) Use a different sheet of paper.
17. Your Hobbies: _____________________________________________________
_____________________________________________________
18. Your Comments; ___________________________________________________
____________________________________________________
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Date: _________________ Sign: ______________________________
.
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