Missions and Me Registration
Registrant Information
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Preferred Method of Contact
*
Please Select
Email
Phone Call
Text
Text + Email
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Registration Questions
Are you registering as an individual or a couple?
*
Individual
Couple
Spouse Name
First Name
Last Name
Registrant T-Shirt Size
*
Small
Medium
Large
Extra Large
2X Large
Spouse T-Shirt Size
Small
Medium
Large
Extra Large
2X Large
Do you have any food allergies?
If so, please let us know.
Who invited you to Missions and Me
*
What skills, gifts, or talents are you hoping to exercise on the field? (Pick up to 3)
*
Business/Entrepreneur
Childcare/Eldercare
Children’s Ministry
Church Planting
Construction/Architect
Educator
Engineering/Technology
Evangelism
Farming/Agribusiness
Finance/Accounting
Fine/Commercial Arts
Foodservice/Culinary
Healing Arts
Health/Wellness
Medical Field
Pastoral Ministry
Retailing
Student Ministries / XA
Writer/Editor
Youth Ministry
What are the top 3 countries you would like to explore for future ministry opportunities?
*
Australia
Cambodia
Fiji
French Polynesia
Guam
Indonesia
Japan
Korea
Laos
Malaysia
Marshall Islands
Mongolia
Myanmar
New Zealand
Palau
Papua New Guinea
Philippines
Pohnpei
Samoa
Singapore
Solomon Islands
Taiwan
Thailand
Tonga
Vanuatu
Vietnam
Payment Information
Missionary and Me Registration
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Individual Registration
$
50.00
Quantity
1
2
3
4
5
6
7
8
9
10
Couple Registration
$
100.00
Quantity
1
2
3
4
5
6
7
8
9
10
Credit Card
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