Church:__________________________________Pastor:_____________________________________
Name(as in passport)
Chinese:______________________________English:________________________________________
Sex: _____________ Age: ____________Nationality:_________________________________________
Role & Ministry in Church______________________________________________________________
Passport Type: ___________________________ Passport No.: ________________________________
Postal Address: _______________________________________________________________________
___________________________________________________________________________________
Phone No. : ___________________________ (Day) ___________________________________(Night)
Pager: ________________________________ Church Phone No.: ______________________________
Fax No.: ______________________________E-mail : _______________________________________
Short term mission destination (please indicate order of preference)
Delhi, India Calcutta, India Philippines
Have you participated in any Cell Church network short term missions before? If so, when and where?
Do you have a burden for long term missions? If so, for which country?
Expectations you have for this short term mission trip:
Your strengths, spiritual gifts and interests:
Languages spoken (indicate level of fluency on a scale of 1 to 5, 5 representing complete fluency)
English ( ) Mandarin ( ) or other : _______________________________________
Please fax or mail this application to reach CCMN office on /before December 31st.
Cell Church Missions Network
P. O. Box 62263, Kwun Tong, Hong Kong
Tel: +852 2772 4760 Fax: +852 2772 4770