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* 1. Your Name:

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* 2. Local Church:

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* 3. Email:

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* 4. Phone:

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* 5. What is your past mission experience? (e.g. participating in/leading UMVIM trips, mission rolesin your congregation, involvement in local mission work, etc.)

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* 6. Have you had any formal training for mission work? (e.g. UMVIM Leader Training or ERTTraining) What training would aid you or your congregation in its mission efforts?

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* 7. Do you have special skills you are willing to share in building our mission network?

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* 8. What mission experiences are you open to sharing with others in the annual conference?

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* 9. What mission experiences would you and others in your local church like to learn more about?

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* 10. Who else in your congregation or circle of influence should we include in our network? Do they have a particular passion or skill we should know about? How do we contact them?

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* 11. Would your congregation like someone to share about missions? If so, what specifically are you interested in learning more about?

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* 12. Are there youth in your congregation or ministry circle who would benefit from access to mission opportunities? Is there a contact we should reach out to? Do you know of particular interests?

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