Please provide the following information:

Author(s) Name   (last, first):
Home Address  (street, city, state, zip):
Affiliation/Organization Address:
Phone:
Email:
Your Designation (Pastor, Dr. Evng. Etc.)
Local church:
Church affiliation:
Length of time in US:
Highest Education Achieved:
Ministry:
List publications, honors received, offices held, membership associations, etc.
Briefly describe yourself here (minimum 120 words).   [Should not exceed one-double spaced typewritten page. Please include: your family, ministry, experiences within Indian community, and ministry goals with Indian community (if any)]
Your Signature:
Date:
Declaration:
Lessons (specify):