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Shimonoseki Christ Bible Church: English Teaching Ministry

Online Preliminary Application
Please take a few minutes and fill out this application completely.  Also, it would be helpful if you would e-mail us a digital photo of yourself here.  Thank you for prayerfully considering the role God wants you to play in bringing many Japanese into His family.

Title:
First Name:
Middle Name:
Last Name:
Preferred Name:
Permanent Address:
Permanent Phone:
Present Address:
Present Phone:
Cell Phone:
Primary E-mail:
Date of Birth (mm/dd/yyyy):
Gender:Male
Female
Marital Status:
Country of Birth:
Country of Citizenship:
Emergency Contact Person #1:
This person's phone:
This person's cell:
Emergency Contact Person #2:
This person's phone:
This person's cell:
Name of College or University:
Date of Graduation (mm/yyyy):
Degree/Diploma:
Major/Minor(s):
Please list any Bible, Teacher, or Missions Training:
Work and/or Teaching Experience (dates, responsibilities, etc.):
Name of Home Church:
How many years have you attended this church?
How would you describe your denominational preference (example: charismatic, non-denominational, fundamental baptist, etc.)?
Home Church Phone:
Name of Pastor(s):
Is your pastor/church supportive of this opportunity?
What is your present church involvement?
When and how did you become a Christian?
In what ways has and is your relationship with Christ growing?
What are your strengths and spiritual gift(s)?
Using Scripture and your own words simply explain the gospel:
Why are you interested in this opportunity and missions?
What overseas experience(s) have you had?
Rate Your Health:
List any major illnesses you've had in the past 5 years:
Are you currently under the care of a physician?Yes
No
Please list any medications you are presently taking and why?
Do you presently have health insurance?Yes
No
What is your first language?
Do you speak any other languages (indicate proficiency level)?
How soon could you come (mm/dd/yyyy)?
How long could you stay?
I've read and agree with the Contract of Service:
I've read and agree with the Statement of Faith:
I've read and agree with the Rules of Conduct:
I've read and agree with the Job Responsibilities:
By checking the next box, I state that all the above information is accurate to the best of my knowledge:
Please list any questions you might have:
How did you hear about this opportunity?
  
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