APPLICATION FOR TERRITORY SELDOM WORKED

(Please type or print clearly)

I will represent a group as the TEAM CAPTAIN.

My name:__________________________________________________________ My telephone number:____________________

(First name) (Middle initial) (Last name) (Mobile/Cellular)

My Email:________________________________________ or _______________________________________________________
(Email. JWPUB address) (Commercial Email Provider e.g. gmail)

My congregation:_______________________________________ ____________________ ___________ _______________

(Name) (City) (Province) (Congregation number)

I verify that my group is able to bear all costs involved in accepting an assignment, including transportation and lodging. Yes No
I have listed in the table below the names of everyone in my group, including me, those from other congregations, and minor children.

TEAM CAPTAIN: Leave this shaded box blank. It is a separate application for those in other congregations to fill out who wish to join your group.

I (We) would like to JOIN a team captain from another congregation. I ( We) list my (our) name(s) in the table below this shaded box.

Team captain’s name:________________________________________________________________________________________

(First name) (Middle initial) (Last name)

Team captain’s congregation:______________________________________ _______________________ _____________

(Name) (City) (Province)

My (our) congregation:__________________________________ _________________________ ___________________

(Name) (City) (Congregation number)

After completing only this box and listing your names( s) in the table below, give this application to your elders for their approval.

NAME Gender Marital Status Accompanied by mate in assignment?

Example: John B. Bwalya (team captain) Male Married Yes
1 Select Select Select
2 Select Select Select
3 Select Select Select
4 Select Select Select
5 Select Select Select
6 Select Select Select
7 Select Select Select
8 Select Select Select
9 Select Select Select
10 Select Select Select
11 Select Select Select
12 Select Select Select
13 Select Select Select
14 Select
Select Select Select
15 Select Select Select
16 Select Select Select
17 Select Select Select
18 Select Select Select
19 Select Select Select
20 Select Select
Select Select
Dates
Please submit at least two possible start dates and corresponding end dates during which you are available to care for an assignment.
(Minimum length of any assignment is one day; maximum length of any assignment is two consecutive months.)

Preferred start date: Preferred end date: Number of days working in service:
Alternate start date: Alternate end date: Number of days working in service:

Distance
How many kilometers (not hours) are you willing to travel from your home area to preach in territory seldom worked? kms

Vehicle(s)
Will the group be using personal vehicles? Yes No What type(s)? __________________________________________________

Are any of the vehicles 4x4? _______________________________________________________________________________________

Unassigned Territory
Choose the areas that your group would like to work from AREAS WITH UNASSIGNED TERRITORY. Write your choices below in
order of preference. The more choices you list the better chances you have in receiving your preferred territory. If the areas you list are
unavailable, you may be asked to work another unassigned territory in the region or to assist a congregation within the distance you stated
above. If your group is available to work any unassigned territory within the distance you stated above, write “ANYWHERE.”

Example: Sioma area, SENANGA 4 8

1 5 9

2 6 10

3 7 11

Assist a Congregation
Choose the DISTRICTS you are willing to travel to in order to assist a congregation that is within the distance you stated above. You can
choose any district. List these below in order of preference. If you can go anywhere to assist a congregation within the distance you stated
above, please write “ANYWHERE.”

Example: MONZE 2 4 6 8

1 3 5 7 9

CONGREGATION SERVICE COMMITTEE’S APPROVAL

Before signing this application, please review the letter addressed to Congregation Service Committees concerning territory seldom worked.

 If you do not approve of the publishers applying, please explain to them why you are not submitting their application.
 Is the information supplied accurate and legible? Is your congregation number as listed on the front correct?

____________________________________ ___________________________________ __________________________________

(Coordinator of the Body of Elders) (Secretary) (Service overseer)

Send the approved application to the Preaching Needs Desk. Make one copy for your files and supply a second copy to the team captain.

Please use JW.ORG mail system. Use the subject line: Seldom Worked Territory — Application

12/19–Ezm