CMIT Applicant Signature- Answered Truthfully and Abstinence Statement


By signing below, I certify that (1) I answered all questions truthfully, with the information contained in this application to be correct to the best of my knowledge, (2) I voluntarily and knowingly authorize U.S. Missions to contact the personal references named attached, and (3) I will abstain from the use of illegal drugs, alcohol, marijuana (unless prescribed by a medical doctor), and tobacco while under U.S. Missions as a missionary associate.

Leave this empty:

Chi Alpha Campus Ministries https://chialpha.com
Signature Certificate
Document name: CMIT Applicant Signature- Answered Truthfully and Abstinence Statement
Unique Document ID: 291ae09efdf2693ec66c54baf82d5f4e62a8b58b
Timestamp Audit
October 18, 2017 4:32 pm CSTCMIT Applicant Signature- Answered Truthfully and Abstinence Statement Uploaded by CMIT Program - cmit@ag.org IP 66.119.29.16
December 6, 2017 12:45 pm CST Document owner mlynch@ag.org has handed over this document to XAAffiliations@ag.org 2017-12-06 12:45:28 - 66.119.29.16
November 26, 2018 4:37 pm CST Document owner XAAffiliations@ag.org has handed over this document to cmit@ag.org 2018-11-26 16:37:47 - 66.119.29.16, 127.0.0.1