Survey - Application - Virtual Team - Orthodox Christian Mission Center

Application - Virtual Team

PERSONAL INFORMATION

Please provide your contact information below:

Name:

Title	First Required	Last Required

Email: Required

Street 1: Required

Street 2:

City/State/ZIP:

City Required	State Required	ZIP Required

Country:

Phone Number: Required

Gender: Required

Date of Birth: Required

Date of Birth:

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CHURCH INFORMATION

Question - Not Required - Parish:

Question - Not Required - Jurisdiction:

Question - Not Required - Priest:

TEAM PREFERENCE

Question - Not Required - Virtual Team Preference:

(Maximum response 255 chars, approx. 5 rows of text)

Question - Not Required - Why would you like to be a part of a Virtual Orthodox mission?

*7.

Question - Required - I am aware that my participation on a Virtual Team is voluntary. I will not use or alcohol, tobacco or illegal substances during our virtual sessions. I will maintain confidentiality of personal information shared by participants in virtual sessions, unless such information could potentially put the person, or someone else, in danger. I will not send or make available any inappropriate materials to others. I agree to conduct myself in a manner befitting an Orthodox Christian rendering service to the Church and Our Lord, Jesus Christ.

Address:
220 Mason Manatee Way
St. Augustine, FL
United States
32086

Phone: (904) 829-5132
Toll Free: 1-877-463-6784
Fax: (904) 829-1635
E-mail: missions@ocmc.org

CFC Number: 10304
EIN: 59-3158396

OCMC is registered under section 501(c)(3) of the Internal Revenue Code.

Contact

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