April 2, 2019 PERSONAL INFORMATION Name: Date of birth: Telephone number: Email address: Country of residence: City of residence: Citizenship: Native language: Secondary language: SCHOOL INFORMATION: Name of University: Current major or field of study: Graduation date: Current job: CHURCH INFORMATION Current church: Current spiritual mentors or Bible teachers: How long have you been attending the church? AM AFFLIATION I am an AM... ---Leader (local, country, or contintental)VolunteerStaffMember / Bible studentGuest AM chapter: SHORT ANSWERS: What do you hope to gain through attending this program? What Bible Study message has impacted your life the most? How do you hope to serve or contribute to building the Kingdom of God on earth? What are your talents or skills? ADDITIONAL INFORMATION: T-shirt size:SMLXL Are you interested in an AM hoodie or sweatshirt? YesNo Do you have any allergies to food or other things?YesNo Do you have a valid driver's license?YesNo Do you have any medical conditions that could affect your stay in the program?YesNo Are you currently on any medications?YesNo Questions, comments, or concerns? Program fee: $150 (includes housing, food, & T-shirt) Contact firstname.lastname@example.org Please leave this field empty.