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PERSONAL INFORMATION
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1.
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Please provide your contact information below:
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*2.
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*3.
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4.
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5.
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6.
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7.
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8.
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CHURCH INFORMATION
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9.
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10.
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11.
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12.
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*13.
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(Maximum response 255 chars, approx. 5 rows of text)
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TEAM PREFERENCE
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14.
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15.
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EMPLOYMENT, EDUCATION AND LANGUAGE
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16.
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17.
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18.
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EDUCATION
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19.
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LANGUAGE SKILLS
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20.
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(Maximum response 255 chars, approx. 5 rows of text)
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EXPERIENCE
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21.
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22.
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23.
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24.
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(Maximum response 255 chars, approx. 5 rows of text)
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25.
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(Maximum response 255 chars, approx. 5 rows of text)
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MISSIONS QUESTIONS
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26.
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27.
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28.
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EMERGENCY CONTACT
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*29.
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*30.
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*31.
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*32.
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33.
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HEALTH INFORMATION
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34.
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35.
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MEDICAL HISTORY
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*36.
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37.
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(Maximum response 255 chars, approx. 5 rows of text)
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*38.
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*39.
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*40.
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41.
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*42.
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43.
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44.
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(Maximum response 255 chars, approx. 5 rows of text)
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ALLERGIES
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45.
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46.
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(Maximum response 255 chars, approx. 5 rows of text)
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MEDICATION
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47.
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(Maximum response 255 chars, approx. 5 rows of text)
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STATEMENT OF CONSENT
The Orthodox Christian Mission Center (OCMC) may contact my parish priest, spiritual father, and references I provide, and /or any organization/institution/affiliation that may have relevant information about my qualification to serve on a mission. I authorize and release from liability such persons and agencies to provide information and background verification as requested by OCMC in order to complete the processing of this application. I acknowledge that all my required vaccinations are up to date, and I assume full responsibility for any additional immunizations that may be required in the country/region of my mission service. I authorize OCMC to retain and rely on this application, and to obtain additional information as needed for my participation in a mission. I understand that OCMC will maintain all information in privacy and confidence, limiting its release only to parties involved with the facilitation and implementation of the OCMC Mission assignment.
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*48.
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