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Missionary Questionnaire
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For Workers returning on Home Assignment
Note: Please complete this form immediately upon arrival in the United States—The information will be sent to the Assistant Vice President/International Ministries via email.
Name
Field
Home Assignment Address
City
State
Zip Code
Phone
E-mail
I/We left my mission residence in
(city)
on (month/day/year)
I/We left the mission field at
(port/city)
on (month/day/year)
I/We arrived in the United States in
(city, state)
on (month/day/year)
The time between my/our departure from the field and my/our arrival in the U.S. was vacation time.
Yes   No
If yes, please list dates (month/day/year) to (month/day/year)
I/We expect to return to the field on (month/day/year)
I/We DO NOT expect to return to the field on schedule.
Briefly explain why
Church Membership
District
Are you supported by an individual, church or group to your knowledge?
Yes   No
If so, give name and address
If married, does the support include your spouse?
Yes   No
If married, does the support include your children?
Yes   No
What types of work have you been engaged in during your past term?
In what schools have you studied since first going to the field?
School
Location
Degree Earned
School
Location
Degree Earned
School
Location
Degree Earned
Name and address of your next of kin
Name
Relationship
Address
City
State
Zip Code
Phone