MISSIONARY AMBASSADORS
                           APPLICANT DATA SHEET

Name(s):                                                                
Current Address:                                                        
City, State, Zip:                                                       
Phone Number (with area code):                  Fax Number (if applicable):    
E-Mail Address (if applicable):        
Name of Mission Organization:                   HQ Phone #:             
Billing Address:                                                        
Capacity & country in which you are/will be serving:                    


Number of U.S. addresses:                Number of foreign addresses:          

Mailed how often: (  ) Monthly   (  ) Quarterly   (  ) Annually   (  ) Other     

Paper Choice:  (  ) White  (  ) Color (please specify if you have a preference)                  

 (  ) Camera-Ready (implies ready to be copied exactly as is)

 (  ) Draft Copy (needs to be re-typed)

Mailing Preference:  (  ) Bulk Rate  (  ) First Class

Other Considerations:                                                   
                                  

If you have your mailing list on a computer, can you supply us a disk in Excel, 
   .dbf, .csv, or ASCII format?  (  ) Yes  (  ) No 
    (Disk must be IBM-PC compatible)
When would you like to start using our mailing service?                 
    (Please allow two weeks for us to load your address list prior to first mailing.)

Any other information we should have?                                             
                                  
                                  
                                  
Please return data sheet to:  mail@missiona.org
       Missionary Ambassadors, 564 5th St SW, Pine Island, MN 55963