Application

Please direct all inquiries to: Mariam Mitry, Associate Director | Phone: 202-832-1762 begin_of_the_skype_highlighting 202-832-1762 end_of_the_skype_highlighting | Fax: 202-832-1762 | Email: mariam@franciscanmissionservice.org.

Name * Title First Middle Last Suffix
Date of Birth * MM / DD / YYYY
Address *
Street Address Address Line 2 City State / Province Postal / Zip Code Country
Home Phone Number * ### - ### - ####
Work or Mobile Phone Number * ### - ### - ####
Email Address *
Martial Status *
Citizenship *
Religious Affiliation *
Number of Dependents (Children and/or Adults)
Education Background

High School
Name of High School *
Address *
Street Address Address Line 2 City State / Province Postal / Zip Code Country
College/University

(Undergraduate)
Name of College or University
Major
Minor
Address
Street Address Address Line 2 City State / Province Postal / Zip Code Country
Date of College Graduation
College Degree
Graduate/Professional
Name of Graduate or Professional School
Area of Study
Address
Street Address Address Line 2 City State / Province Postal / Zip Code Country
Date of Graduation
Degree
Occupational Background

(Please list current or most recent employment first.)
Type of Work #1 *
Dates of Employment #1 *
Agency/Employer #1 *
Address #1 *
Street Address Address Line 2 City State / Province Postal / Zip Code Country
Type of Work #2
Dates of Employment #2
Agency/Employer #2
Address #2
Street Address Address Line 2 City State / Province Postal / Zip Code Country
Type of Work #3
Dates of Employment #3
Agency/Employer #3
Address #3
Street Address Address Line 2 City State / Province Postal / Zip Code Country
Foreign Language Proficiency:
Language 1
Proficiency Language 1
Language 2
Proficiency Language 2
Language 3
Proficiency Language 3
Short Essay Questions

Please describe your relevant experiences and answer the following questions.
Significant Educational Experiences: *
Cross-Cultural Experiences: *
Travel Experiences: *
Past Volunteer Experiences (include dates): *
List any special skills, training, or qualifications that you feel will be helpful while on mission: *
What are your extra-curricular interests and/or hobbies? *
Describe any physical and/or mental health issues you may have: *
Describe your faith life. What role (if any) does it play in your decision to go on overseas mission? *
What is your idea of simple living? *
Our program is modeled on the Franciscan ideal of living and working with the poor and marginalized. Do you feel called to mission among the oppressed and marginalized, and if so why? *
Evaluate your ability to live and work with others. What qualities help and/or hinder you? *
What type of work would you like to do on mission? *
Why do you want this international mission experience? *
Have you ever been convicted of a felony or misdemeanor crime? If yes, please explain below. *
Yes No
Have you ever had any alcohol or drug problems? If yes, please explain below. *
Yes No
Please add any other additional information you think would best help us get to know you better.
When are you interested in entering formation? *
Fall 2012 Fall 2013
How did you hear about FMS? *
If other, please specify below:
Beckford Personal Inventory - Scale 5

Please rate yourself on the following characteristics and abilities (1=one of my weak areas; 2= I need improvement; 3= I’m proficient; 4= I’m confident; 5=one of my strengths).
Creativity *
Initiative *
Sensitivity *
Independence *
Dependability *
Sense of Humor *
Maturity *
Self-confidence *
Leadership *
Team Approach *
Organizational skills *
Flexibility *

Total: $0.00

Franciscan Mission Service
P.O. Box 29034
Washington, DC 20017-0034

T: 202-832-1762 | F: 202-832-1778

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INITIAL APPLICATION: Long-term Mission Program

Education Background

College/University

Graduate/Professional

Occupational Background

Foreign Language Proficiency:

Short Essay Questions

Beckford Personal Inventory - Scale 5