STUDENT LITERATURE EVANGELIST APPLICATION Laisser ce champ videLaisser ce champ videLaisser ce champ vide * Champs obligatoires REGISTRATION FORM Name / Nom Premier Dernier Sex / Sexe Male / Homme Female / Femme Marital Status / État Matrimonial Single Married Name of Spouse if Married / Nom du conjoint Si vous êtes marié Age Bracket / Tranche d'âge Below / Moin de 15 15 - 20 21 - 25 Above / Plus de 26 Place of Birth / Lieu de naissance Residential Address / Adresse de résidence Adresse 1 Adresse 2 Ville Select a State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin WyomingEtat Code postal Pays Whatsapp Number / Numéro Whatsapp Email Name of your School / Nom de votre établissement School Id Number / Numéro d'identification Faculty / Faculté Course of Study / Filière suivie Residence / Résidence School Registrar Approval Number / Numéro d'agrément du registraire scolaire ** Student Development Approval Number / Numéro Approbation du responsable de développement de l'étudiant Spiritual Life Approval Number / Numéro d'approbation du responsable de la vie spirituelle Sale Approval Number / Numéro d'agrément de vente** Have you Canvassed Before? / Avez-vous déjà fait du Colportage? Yes / Oui No / Non Were You Owing Any Conference - Union? / Est-ce que vous devez de lárgent a une federation / Union? ** Yes / Oui No / Non If Yes, Name of the Conference / Union - Si oui, nom de la Fédération / Union State - Region Of Origin / État - région d'origine L.G.A / District Home Town / Ville natale Place of Baptism / Lieu de baptême Date of Baptism / Date du baptême yyyy/mm/dd Baptized By / Baptisé par Current Place of Membership / Lieu d'adhésion actuel Conference / Fédération Union Cameroon Union Mission Central Africa Union Mission Eastern Nigeria Union Conference Southern Ghana Union Conference Northen Ghana Union Conference Eastern Sahel Union Mission Western Sahel Union Mission Western Nigeria Union Conference Northen Nigeria Union Conference West Africa Union Mission UNION / CONFERENCE OF CANVASSING 1st Choice / 1er choix 2nd Choice / 2e choix Country of Choice / Pays de choix Guarantor's Name / Nom du garant Email Guarantor's/ Email du garant Guarantor's Address / Adresse du garant Adresse 1 Adresse 2 Ville Select a State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin WyomingEtat Code postal Pays Whatsapp Number / Numéro Whatsapp I, (STUDENT)……………………………………………………………….... HEREBY PLEDGE TO ABIDE BY THE RULES AND REGULATIONS GOVERNING CANVASSING AS STATED IN THE SALE CONSTITUTION WHEREVER I WILL BE CANVASSING. IF I DEFAULT IN ANYWAY, MY REPORT SHOULD BE SENT TO MY SCHOOL AND MY GUARANTOR. STUDENT SIGN.: ……………………… ………... DATE: ……………………… ………... GUARANTOR SIGN.: …………………………... DATE: ……………………… ………... PLEASE NOTE 1. Your name and that of your guarantor on this form stand as signature. 2. **Are compulsory fields. Your form may not be approved if you do not fill these. 3. Registration for 2021 summer canvassing closes April 30, 2021. 4. Ensure you get a letter of invitation from your host before setting out to your canvassing location. 5. Students (SDA) from non-Adventist institutions are welcome under special arrangement.