MEI Account Number
First Name
Last Name
Nickname
Permanent Address
Permanent Address Opt.
Permanent City
Permanent State / Province
Permanent Zip Code / Postal Code
Permanent Country
[Select]
United States
Canada
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua & Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia/Herzegovina
Botswana
Brazil
British Indian Ocean Territory
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canary Islands
Cape Verde Islands
Cayman Islands
Central African Rep.
Chad
Channel Islands
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoro Islands
Cook Islands
Costa Rica
Cote d’Ivoire
Croatia
Cuba
Cyprus
Czechia
Democratic Rep. of Congo
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldive Islands
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
North Korea
Northern Marianas
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Republic of Congo
Réunion
Romania
Russia
Rwanda
Saint Barthelemy
Saint Martin
Samoa
San Marino
São Tomé & Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Korea
South Sudan
Spain
Sri Lanka
St. Helena
St. Kitts & Nevis
St. Lucia
St. Pierre & Miquelon
St. Vincent & the Grenadines
Sudan
Suriname
Svalbard
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tokelau
Tonga
Trinidad & Tobago
Tunisia
Turkey
Turkmenistan
Turks & Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Virgin Islands (U.K.)
Virgin Islands (U.S.)
Wallis & Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Is your Mailing Address Different?
Yes
No
Mailing Address Opt.
Mailing City
Mailing State / Province
Mailing Zip Code / Postal Code
Mailing Country
Email
Date of Birth
Skype
Instagram Profile
WhatsApp Profile
Facebook Profile
Snapchat Profile
LinkedIn Profile
Contact Number
Are you a US Citizen?
Yes
No
Tax Filing Status - are you required to file taxes in the USA?
Yes
No
Will you ever travel to the USA?
Yes
No
Give dates and details of any projected travel to the USA for the entire year.
List all countries of citizenship for applicant
Are you married?
Yes
No
Spouse First Name
Spouse Last Name
Spouse Nickname or Preferred Name
Spouse Date of Birth
Is your spouse a US Citizen?
Yes
No
Is your spouse is required to file taxes in the USA?
Yes
No
List all countries of citizenship for your spouse
Please attach a recent photo of all applicants.
Do you have a home church?
Yes
No
Name of Church
Church Website
Church Phone Number
Pastoral Reference Name
Pastor's Email
Pastor's Phone Number
What is the name of the Ministry with which you will be working?
Ministry Leader or Director
Ministry Location - Please list City, State, Country
Housing Expense $, (for example Housing, Travel/Special Lodging)
Office Expenses $, (for example Printer Ink, Stationary)
Transportation Expenses $, (for example Flight, Rental Car, Fuel)
Shipping and Postage $, (for example Postal Carrier Fees)
Communication Expenses $, (for example: Phone, Newsletters, Printing)
Meal Expenses $, (for example Travel or Special Meals)
Other Expense Items
Other Amount $
By submitting this Agreement, I (we) are agreeing to the terms and conditions of this application and any Mission Enablers International requirements. I (we) understand our obligations and consent to comply with all regulatory, legal, and internal changes, updates and adjustments that the Board of Directors might implement.
I understand that an additional Agreement may be needed for short or long term, temporary or permanent, and/or other projects at any time.
Under penalty of perjury, I confirm that the information submitted in this form is true and accurate to the best of my knowledge.
By submitting this Agreement, I (we) understand that I (we) will report any and all information need by Mission Enablers International upon request. This may include but is not limited to, fiscal updates, ministry changes, staff and personnel changes, and program changes.
By submitting your application and authorization, you acknowledge that MEI is a Texas non-profit organization that is tax exempt under I.R.C. § 501(c)(3) and MEI exercises complete discretion and control over all funds received and reserves the right to deny services and allocate funds toward any activity consistent with its purpose.
Signature (Type Your Name to Sign the Form)
Submit