By completing the request form below, you will receive free information from the mission/service opportunities that you request, and be entered in the $1,000.00 Missions scholarship drawing. For drawing details, you may review the drawing rules page.

(Items in blue are required.)
Your plans and interests... When are you considering serving/attending? select one This year Next year Next 5 years Do not know Desired type of service select one Short term (1 day up to 2 years) Missions Training Long term / Career (over 2 years) Where are you willing to serve? (check all that apply)  Anywhere  Africa  Asia  Australia  Canada  Caribbean Islands  Central America  Eastern Europe  South America  South Pacific  United States (rural)  United States (urban)  Western Europe  Other Country of interest On a scale of 1 to 10, with 10 meaning "very seriously", how seriously are you considering missions/service? select one 10 9 8 7 6 5 4 3 2 1 Your church... Church/organization I represent (if applicable) Church denomination select one Apostolic Assembly of God Baptist Baptist (American) Baptist (Freewill) Baptist (Independent) Baptist (Mission) Baptist (Southern) Berean Bible Calvary Chapel Catholic Charismatic Christian Church Christian Miss. Alliance Christian Reformed Church of Christ Church of God Church of God in Christ Community Congregational Covenant Disciples of Christ Episcopal Evangelical Evangelical Covenant Evangelical Free Foursquare Friends Full Gospel Holiness Independent Independent Church of Christ Lutheran Lutheran Evangelical Mennonite Mennonite Brethren Methodist (AME) Methodist (CME) Methodist (Free) Methodist (United) Methodist (Wesleyan) Missionary Nazarene Nondenominational Pentecostal Presbyterian Presbyterian (PCA) Presbyterian (USA) Reformed Seventh Day Adventist United Church of Christ Vineyard Wesleyan Other My Christian experience is (check all that apply)  Charismatic  Confessional/traditional  Evangelical  Fundamental  Non-denominational  Pentecostal  Unsure Are you willing to raise your own support? Yes    No   Is your home church aware of your interest in missions? Yes    No          Your skills (optional)... Highest degree completed select one Current high school student High school / GED Certification Associates Bachelor Graduate level / Seminary Doctorate Special skills: Language proficiency (other than English) Special skills: Cross-cultural experience Skills (check all that apply)  Administration  Agriculture  Communications  Construction  Education  Engineering (Other)  Engineering (Water)  Finance  Health Care  Marine  Ministry Skills  Service Industries  Technical Skills  TESL / TEFL In which skills do you have the most experience and training?        Your contact information... First name M.I. Last name Street address City State/Province/Region select one outside US/Canada Alabama Alaska Alberta Canada Arizona Arkansas British Columbia Canada California Colorado Connecticut Delaware Dist. of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Canada Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland North Carolina North Dakota Northwest Territories Nova Scotia Ohio Oklahoma Ontario Canada Oregon Pennsylvania Prince Edward Island Quebec Canada Rhode Island Saskatchewan Canada South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Yukon Territory I live outside the US/Canada Zip/postal code Country Email address Home phone Work phone Fax        More about you... I am a select one High school student College student Other adult Group/team leader Pastor / youth pastor Gender select one Male Female Date of birth month JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember day 12345678910111213141516171819202122232425262728293031 year 194019411942194319441945194619471948194919501951195219531954195519561957195819591960196119621963196419651966196719681969197019711972197319741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999 Age Marital status Single     Married     Other   If married, is spouse also interested in serving in missions? Yes     No   Spouse's name (if interested) Citizenship select one U.S. Citizen (or Green Card) Canadian Citizen Other If other, country of citizenship        Wrapping things up (optional)... How did you hear about the Christian Connector website? select one Advertising Air1 Card packet mailing ChristianPost.com Email Received Friend High school guidance counselor High school principal KLove OurChurch.com Pastor / Youth Pastor Search Engine - Altavista Search Engine - AOL Search Engine - Google Search Engine - Hotbot Search Engine - Lycos Search Engine - MSN Search Engine - Yahoo Search Engine - Other Comments