Pre-Application Form for SOS Missionaries

name
address
city state zip
personal phone work phone
email

1. Please indicate areas of interest:
home team  travel team both

2. If travel team, please indicate:
faith sharing mission  vision screening mission
cataract surgical mission no preference

3. Have participated in any missionary activity before? yes  no
  If yes, please list when and where?
  Enter info here

4. Do you speak Spanish? yes no
Are you fluent? yes  no
 
5. Have you traveled outside of the U.S.A?
yes  no

6. Do you play a musical instrument? yes  no
if yes, identify instrument(s)

7. Please check areas where you see yourself potentially sharing your skills, talents or interest.

Computers	Educational	Volunteer Areas	Medical	Medical Related	Occupational Expertise
Data Entry Programs:   Excel   Word   PP Programming Websites Other specify	Teachers:   ESL   School Teacher Grade Religious Education Age Group Lesson Planning Spanish Translator On-Mission Translator Translating Documents	Bulk Mail Outs Creative Writing   Newsletters   Web Articles Fund Raising Phone Calling Photography Public Speaking Sewing Visual Aides Other specify	Anesthesiologist Dentist Doctor  specialty Nurse  specialty Optician Optometrist Surgeon  specialty Other specify	CPR Optometry Tech Other specify	Accounting Banking Carpentry Clergy Construction Deacon Lawyer Marketing/Pub Printing/Adv Religious Order Other specify

8. Please identify your parish or faith community affiliation

9. Please identify areas of current ministry involvement or community service


10. Age: 18-23  24-30 31-40  41-50 51-60  61-70  71+

11. If currently a student please indicate:  current grade level
 name of school

6. Do you want to receive periodical S.O.S. information by email and/or mail?
yes  no