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ACM International Interest Form
cultivating relationships that make disciples
Title
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Mr.
Mrs.
Miss
Name
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First
Last
Gender
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Male
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Marital Status
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Single
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Number of Children
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1
2
3
4
5
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Antigua and Barbuda
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Jamaica
Mexico
Netherlands Antilles
Nicaragua
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United States
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Finland
France
Georgia
Germany
Greece
Hungary
Iceland
Ireland
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Kosovo
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Macedonia
Malta
Moldova
Monaco
Montenegro
Netherlands
Norway
Poland
Portugal
Romania
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Serbia
Slovakia
Slovenia
Spain
Sweden
Switzerland
Ukraine
United Kingdom
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Afghanistan
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Myanmar
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China
East Timor
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India
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Iran
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Israel
Japan
Jordan
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Russia
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Singapore
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Thailand
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Vietnam
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Australia
Fiji
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Marshall Islands
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Nauru
New Zealand
Palau
Papua New Guinea
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Solomon Islands
Tonga
Tuvalu
Vanuatu
Algeria
Angola
Benin
Botswana
Burkina Faso
Burundi
Cameroon
Cape Verde
Central African Republic
Chad
Comoros
Democratic Republic of the Congo
Republic of the Congo
Djibouti
Egypt
Equatorial Guinea
Eritrea
Ethiopia
Gabon
Gambia
Ghana
Gibraltar
Guinea
Guinea-Bissau
Cote d'Ivoire
Kenya
Lesotho
Liberia
Libya
Madagascar
Malawi
Mali
Mauritania
Mauritius
Morocco
Mozambique
Namibia
Niger
Nigeria
Rwanda
Sao Tome and Principe
Senegal
Seychelles
Sierra Leone
Somalia
South Africa
Sudan
Swaziland
United Republic of Tanzania
Togo
Tunisia
Uganda
Zambia
Zimbabwe
Country / Region
How do you prefer to be contacted?
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E-Mail
Phone
Snail Mail
Assignment Type
Internship (8-10 Weeks)
Faith Corps (1-2 Years)
Long-term Missionary
Other
Primary Ministry Interest
Evangelizing the Unreached
Empowering the Oppressed
Developing Communities
Raising Disciples
Other
Readiness Status
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Send me now!
6 months out
1 year out
More than 1 year
I'd like to know more about...
How did you hear about ACMI
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Mission Convention
Church
Friend
ACMI Missionary
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