Include Photo of Missionary

(If sending this form electronically, please send

the photo as a separate attachment)

Initial Report For A Missionary

Serving The Lord Through A Native Mission

Report Date:

Mission Name

Your Name:

Birth Date (Day/Month/Year)

Country

Province

Spouse's Name
Children's Names/Ages

Languages You Speak

Housing:
Check All Boxes That Apply To Your Situation:
Made Of:

Location:

Usual Climate:

Apartment

Stone

City (75,000 or more)

Hot

Renting

Wood

Town

Cold

Own House

Mud

Villagel

Warm

Bamboo

Rural

Dry

Thatch

Jungle

Wet

Brick

Mountainous

Your Family

Alone

Believers

Primary School

Secondary

Technical

Bible School

Seminary

College

Trained in local church

With Whom Do You Live?:

Parents
Other (specify):

Education Received:

List degrees earned

Your Main Missionary Responsibilities (Check One Or Two):

Administrator

Bible Translator

Children's Worker

Church Planter

Counselor

Evangelist

Medical Missionary

Music Minister

Pastor

Supervisor of Missionaries

Other (specify):

Teacher

Which Best Describe Your Missionary Activities?

Bible classes

Children outreaches

Literature distribution

Counseling

Student work

House visitaion

Gospel team

Open-air preaching

Bible School teacher

Other (specify):

Major Religions In The Area Where You Minister:

Islam

Buddhism

Hinduism

Sikhism

Animism

Taoism

Judaism

Roman Catholicism

Other (specify):

Check All Boxes That Apply To The Primary Groups Of People You Reach:
City dwellers

Farmers

Factory Workers

Students

Military

Professionals

Children

Women

Unemployed

Poor

Illiterate

Educated

Tribals (name tribes or

people groups -- be specific)
If Applicable, Which Unreached
Tribes Are You Targeting?

Kinds Of Transportation Used In Your Missionary Work:

Boat

Horse

Bus

Car

Truck

Motorcycle

Cart

Bicycle

Walking

Please List Prayer Requests:

Other (specify):

How, When, And Where Did You Become A Christian?

(Give as much detail as possible, and use an additional sheet of paper, if necessary.)

Name of person who completed report: