Personal Information: (for public use)
Personal Information: (list numbers intended for office use only)
Family Information: (optional)
|Degree(s) earned with school information:
|WMU positions held in state, association or church:
|Other missions-related experiences:
Consent for the public use of your name and information:
Mississippi WMU provides a Specialized Workers Directory to mission leaders, churches associations, and others as needed. The
personal information you indicated above - for public use - will be included in the MS WMU Specialized Workers Directory. The
directory will be available through several mediums and formats including, but not limited to: print, cd’s, and the internet (MS
WMU’s Leadership Development webpage).
By typing your name on this form you are giving MS WMU permission to include your personal information in the MS WMU Specialized
Worker Directory and agree to this information being available to the general public.
If you agree to give MS WMU permission to use your personal information in the mediums and formats mentioned above, please type
your name and date on the line below.
I do hereby give MS WMU permission to use my personal information in the MS WMU Specialized Worker Directory. I understand that
my information will be available to the general public through but not limited to: print, cd’s and the internet.
I agree that typing my name above gives MS WMU permission to use
my personal information as outlined.