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, (3) I understand and agree to abstain to abstain from using tobacco, alcohol, marijuana (unless prescribed by a medical doctor), illegal or recreational drugs in any form, and involvement with pornography, (4) I have never been involved and will not be involved with inappropriate sexual contact with a child, and (5) I will abstain from sex outside of marriage while under U.S. Missions assignment.

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Document name: Missionary Applicant Signature- Answered Truthfully and Abstinence Statement

Unique Document ID: d66fa4f513f9b897c820b515c18a7dda595605b9

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Timestamp	Audit
October 18, 2017 4:32 pm CDT	Missionary Applicant Signature- Answered Truthfully and Abstinence Statement Uploaded by Chi Alpha Affiliations - [email protected] IP 66.119.29.16
December 6, 2017 12:45 pm CDT	Document owner [email protected] has handed over this document to [email protected] 2017-12-06 12:45:28 - 66.119.29.16
November 26, 2018 4:37 pm CDT	Document owner [email protected] has handed over this document to [email protected] 2018-11-26 16:37:47 - 66.119.29.16, 127.0.0.1
October 20, 2020 3:05 pm CDT	Document owner [email protected] has handed over this document to [email protected] 2020-10-20 15:05:47 - 199.192.158.121
October 23, 2020 2:28 pm CDT	Document owner [email protected] has handed over this document to [email protected] 2020-10-23 14:28:50 - 66.119.29.16
October 23, 2020 2:30 pm CDT	Document owner [email protected] has handed over this document to [email protected] 2020-10-23 14:30:04 - 66.119.29.16
October 23, 2020 2:50 pm CDT	Document owner [email protected] has handed over this document to [email protected] 2020-10-23 14:50:27 - 66.119.29.16

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https://chialpha.com/

Audit Trail Serial# 8d98eabd4632a1848e66dc3d4274d0b4