Interested in Serving?Fill out the form below to express your interest! Name * First Name Last Name Date of Birth * MM DD YYYY Email * Phone * Country (###) ### #### Location * Which Imagine Nations Church are you from? Sydney Melbourne Canberra Phoenix Other General Information Why do you want to go on this missions outreach? * How would you like to contribute on this outreach? What are your areas of gifting/ skills/ expertise? * Should you be accepted on this outreach you will be required to attend a number of team meetings prior to departure, participate in all team activities whilst there (including prayer meetings, planning sessions etc) and debriefing sessions at the end of the trip. Do you anticipate any difficulties in doing so? * YES NO When and where were you saved? * Are you baptised in the Holy Spirit? * YES NO Have you been baptised in water by full immersion? * YES NO Have you attended an Encounter Weekend? * YES NO Whose Connect Group do you belong to? * Please provide contact details of your leader in order to provide a reference for you: * List other areas of Church Involvement * Serving I am interested in * Short Term (2 - 4 Weeks) Long Term (1 Year) Thank you!