APPLICATION FOR SELDOM-WORKED TERRITORY

(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) (Area code and number)

My address:_________________________________________ __________________________ _____ ____________

(Street address or box) (Town/Suburb) (State) (Postcode)

My congregation:___________________________________ ___________________________ _____ ______________

(Name) (City) (State) (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 every name of all in my group, including myself, those from other congregations, and minor children.

TEAM CAPTAIN: Leave the shaded box below 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) (State)

My (our) congregation:_________________________________ ________________________ _____ ______________

(Name) (City) (State) (Congregation number)

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

NAME Race Gender Marital Status Accompanied by mate in assignment?

Example: John J. Johnson (team captain) W M Married Yes

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

Unassigned Territory
List the general location(s) or area(s) that your group would like to work. 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 locations 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.”

Assist a Congregation
Choose the areas you are willing to travel to in order to assist a congregation that is within the distance you stated above. You can
choose any area. 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.”

CONGREGATION SERVICE COMMITTEE’S APPROVAL

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

• 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 Territory Desk. Make one copy for your files, and supply a second copy to the team captain.