Template1

General Information

Date:

Name:

Home Phone:

Cell Phone:

Address:

City:

State:

Zip:

Date Of Birth:

Marital Status:

Single

Married

Occupation:

Email Address:

Do you have any Clerical or ministerial certifications?	Yes	No
Can you provide a copy of the certificates?	Yes	No
Do you have a valid Driver’s license in the US?	Yes	No

Emergency Information

Name:

Relationship:

Address:

City:

State:

Zip:

Phone:

Email Address:

Background Information

Have you served in the mission field, or as a pastor in the past?

Yes

For how many years and where?

What area (denomination, geography, etc) would you feel most comfortable working in?

Do you have many pastoral acquaintances in this area?

Have you ever heard about ECHOcuba before?

Yes

How did you hear about our program?

Thank You!

The Mission & Work
Of Echo Cuba

Horizon Media Studio’s TV Series, Revelations, takes a look at the mission and work

Cuba, the Cuban Persecuted Church, and Cuban Liberation Theology

The Communist island's improbable revival is 15 years old and growing stronger.