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:

AM AFFLIATION

I am an AM... —Please choose an option—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 and spreading the Gospel of Jesus Christ on earth? What are your talents or skills?

ADDITIONAL INFORMATION:

T-shirt size:SMLXL
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: TBA (includes housing, food, & T-shirt)

Contact alma@amintl.org

Please leave this field empty.

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