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This form is prepared to help you give accurate background information about yourself and your mission work.
'Please do not write on this form anything other than that requested. Attach extra sheets for additional information you may want to provide.
This Is not an application form. It is not an official form endorsing you and your work. It is simply a worksheet designed to help us publicize
your work that may help produce new friends for you, prayers and financial assistance. If any questions seem too personal or seem offensive
to you, please feel free to leave them blank.
Date:
(Month
Name in full
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Pirsi Name
(Number
Street
Mipdle Name
Cily
Day
Year)
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Zip number
Country)
State
Ask for:
(First
Middle
P (Number
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SI
Street
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State Zip)
^
City
phone number
7~ TO
City
- State
Zip
City:
State
Zip
Names and addresses of other sponsoring churches whose elders recommend you:
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City:
(Full
(FuU name of church)
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Zip
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City:
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State
Zip
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Please sketch a map directing visitors to your location on the mission field
Recommendations by Christian Leaders: (List names here and enclose a copy of each letter.]
Name;
Of ^
City:
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Name
City
Number &Street
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State
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Zip
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State
City
Place of Birth
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Zip
Zip
State
Date of birth
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3
(Day)
(Month)
(Year)
(Year)
(Day)
(Month)
(Day)
if applicable.)
fVear;
Date
State
Zip
On an extra sheet please describe any details regarding your conversion which you might care to mention..
MARITAL STATUS;
Married
Single
Divorced
Widowed
Please give the complete name of your husband or the maiden name of your wife
Date of marriage
,
(Month)
(Day)
Where married?
(Year)
List children by full name giving the place, birthday, month and yearin the order of yourchildren's birth days. (Ifyour
children have been adopted please indicate.) In case you are single, please list your brothers and sisters by name in
this space.
Name
Place of
birth
Month,
Day
Year
Please list places of previous Christian service and what service you did as a brief career summary.
Give
approximate dates:
Service
Position
Place
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Dates
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Number of years
Location
Name of school
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Is your
purpose
in
lA.pcu=ion
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missions?
Or what
do
you
hope to
accomplish on
the
mission
field?
Your own explanation in some detail might be influential In leading others into fuli-tlme service. (Use extra sheets if
you need more space):
Describe briefly in outline form the nature of your daily duties on the field:
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Which of the following terms most nearly describes your missionary status?
Evangelist
Bible College Teacher
Bible Reader
Public School Teacher
Homemaker
ministry
Doctor
Nurse
Radio follow-up
mission equipment
Correspondence Courses
Evangelism
Name
Social Worker
Maintenance
Benevolent
Pilot
Music Teacher
Linguistics
Office Work
Maintenance of
Production of Bible
Radio
Village
PARENTS:
Living
(First
Deceased
Number &Street
City r.hipQ-jj-Q
State
\Q.
Middle
ij
Last name)
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Zip
Phone
His occupation
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Is he a Christian? Yes
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No
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(First
Living
Deceased
r.ity
Is
she a
home
Number &Street
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Christian?
Yes
Middle
lS_ai
, state
\y
Last name)
Zip
No
Phone
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What leadership positions or Christian service has she rendered to the local church?
Do you have relatives in mission work? Yes
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No
If so, please list their names, location, kinship and details on a separate sheet with a brief explanation of their
missionary activity.
FORWARDING AGENT:
Name
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State
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(First
1003
Middle
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Lastriame.
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Zip
, City
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City
Phone
^95-3-^
PKul-cJ'N
State
Zip
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Please give details of HOW checks should be written to this mission: C^ATraA A-^ncQufN
If funds are to be sent directly to the missionary on the mission field, please explain the details of HOW to do it, so we
can give your explanation to HORIZONS readers and others who may inquire
Mission Services Association is depending upon you to keep her informed regarding your missionary activity.
Thanks so very much; you are the BEST source for your information we know, so you are a vital partner.
If you have additional information that you think will be helpful to the staff of MSA in preparing news stories about
your ministry, please feel free to send it. MSA is depending upon you. Thanks.
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Johnson
Bible College
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ADDRESSES
Home Address
Forwarding Agents:
Frank and Rosemary Manzenberger
1003 Eric Avenue
Oolitic. IN 47457
PEOPLE
PRAYER REQUESTS
Zimbabwe.
and children's
message.
J
/r.
&
PLANS
1. To assist Jack and Peggy
Pennington in the English-speaking
work of Harare.
2. To work with the Arcadia Christian
Church
In
Christian
education,
INDIVIDUAL NEEDS
Service Link
Living Link
$500.00
$490.00
Initial Expenses:
Vehicle
Shipping Cost
Airplane ticket
$8,000.00
$700.00
$1,000.00
Cash reserve
Other Needs:
Typewriter
Teaching materials
Household appliances (220 voltage)
Delaneys to Zimbabwe
November 1, 1984 is the date second-
also
at
I.S.
in
Lusaka,
but
she