Become a Member of Kansas Nebraska Campers on Mission PrefixMr.Mrs.Ms.Mx.MissDr.Prof.First NameMiddle NameLast NameDate of BirthCell PhoneEmail AddressSpouse NameSpouse Date of BirthStreet AddressApartment, suite, etcCityState/ProvinceZIP / Postal CodeSpouse Cell PhoneSpouse Email AddressPastor NamePastor or COM name referencePastor PhoneName of Church MembershipName of church and demoninationChurch PhoneStreet AddressCityState/ProvinceZIP / Postal CodeCheck type of projects in which you have participatedCOMNAMBIMBLocal Church ProjectState ConventionOtherHave you participated in a mission project.List Areas Of Special TrainingCampground MinistriesChurch PlantingConstruction / MaintanceDisaster Relief / RecoveryFairs, Festivals, Special EventsCommunity Survey, RevivalsPersonal TestimonyState Convention BoothsVBS, Bible StudyClowns, FacepaintingRaceway MinistriesSeaman’s MinistriesOtherEmergency Contact NamePerson to contact if you are not able to communicate.Emergency Contact PhoneCampers On Mission Statement of FaithSignatureBy typing my name in the signature box, I agree with COM Statement of Faith and will endeavor to live my life guided by the scripture it is based on.Spouse SignatureBy typing my name in the signature box, I agree with COM Statement of Faith and will endeavor to live my life guided by the scripture it is based on.Date Signed and SubmittedSend Message