Membership Application Form - 2001
INTERNATIONAL ASSOCIATION OF CATHOLIC MISSIOLOGISTS ( IACM )
(In
block letters, please)
Surname
Name (and
middle initial):
...
..
Date of birth (date/mo./yr.)
../
../
.. Priest / Religious / Layperson (Title)
..
Present Position:
.
Institution:
.
..............................................................
...
City
...
..
State/Province
.,.Country
.
Phone(with national and regional prefixes) + .....Fax + ... .
E-Mail : @
|
Preferred
Contact Address:
..
.
...
....
.
|
Educational Qualification (Highest degrees
first, then others)
.............................................................................................................................................................................................................................................................................
Books or Articles Published (Three most important or recent publications)
Specialized Field of Research/Ministry:
Membership Category (Check one)
Individual: X Professor of
Missiology or related discipline
X Writer on Mission-related issues X Researcher on Mission-related issues
Corporate: X Academic Missiological Faculty
/ Institute X Missiological
Research Institute
Name of Institution:
Associate: X Student of Missiology (candidate for a graduate
degree)
X I will send
copies of my future publications (papers,
essays, books).
We would appreciate a brief bio-data
of yours on a separate sheet.
Place and Date
Signature
.
.
Please return this form, duly filled
in, by post, or fax, or Email, to:
|
Executive Secretary, IACM Pontifical Urban University Via Urbano VIII, 16 I - 00165 ROME, ITALY Fax: (+ 39) 06.6988·1871 |
Or to: President, IACM Instituto
de Misionologνa,UCB Casilla Postal 2118 COCHABAMBA BOLIVIA Fax: (+591·4) 56-2670 |
Email: |