From:
"Jack Klassen" <jklassen@msn.com> | Block address
To:
"Susan Rochat" <rochat@rocketmail.com>
Subject:
India
Date:
Mon, 25 Sep 2000 16:29:51 -0700
Organization:
Microsoft Corporation
Add Addresses
Hello Susan (and Roger),
It's exciting to know that you'll be part of The Presbyterian Experience in India. I've attached 2 items. Please fill in
the areas needed and email them back ASAP. We have compiled the biographies of all the travelers and are
prepared to send them out. We want to include yours.
Sorry for the rush act - - - we're against deadlines. In the next day or so, I'll mail all the information that we've mailed
in parts to the other travelers so you'll be up to speed at least with the rest of them.
Take care,
Jack
Touching the Untouchables
_______________________________
Jack W. Klassen
Witnessing Ministries of Christ
Northwest Region Office
220 Beacon Street
San Francisco CA 94131
Tel: (415) 641- 1114 Fax: (415) 821-2643
The Presbyterian Experience in India - Application
Title Mrs._ __ Name ___Susan Ruth Rochat______________ DOB __3-23-44_
Home Address 1010 Liawen Court____ City, State & Zip Atlanta, Georgia 30329-4122
Mailing Address __same________________________ City, State, & Zip _________________________
Home Phone __404-321-6845____________ Work Phone ____Roger: 404-712-9506
FAX __Roger 404-727-8737_______ E-mail __Rochat@rockematil.com or rrochat@sph.emory.edu___
Home Church and City _North Avenue Presbyterian, Atlanta__ Citizenship __USA_
Passport #159120758_ Issue Date _09/98 Expires __08/08_ Place Issued _National Passport Center_
Emergency contact person __Roger W. Rochat____ Relationship_Husband___
Phone(s) _404-321-6845; cell 404-401-5926, office 404-712-9506_ E-mail see above
Describe your interest and/or involvement with Witnessing Ministries of Christ__ I only heard of this organization today! However, I am interested in missions, especially in the country of my birth. Becoming a Christian has affected every aspect of my life in a positive way and I would like to be able to share that with others.
Have you traveled to a third world country? Where, when, & for how long? Purpose? Use back, if needed.
Born and raised in India 1944-60; visited India 1 wk. 1968; lived in New Delhi 1986-88. Visited Dominican Republic 1999 1 wk. to see our daughter who was studying there. Visited husband 1 wk. who was working in Bangladesh 1968.
What is your current state of health? (Circle one) Excellent Good Fair Poor
Please explain any health concerns that will affect your travel? (i.e. diabetes, asthma, allergies, heart, etc.)
_I have asthma and allergies. I have excellent medications and care and exercise several times a week.
List any restrictions (physical, emotional or dietary). Must avoid feather pillows, dust, molds, cats, horses and can’t eat shellfish.
Does your health insurance provide coverage for you while outside of the US? _____ Yes __x__ No
Health Insurance Provider _Tricare-primary; Mediplus sec_Health Ins. I.D. # Sp ID 535365256
Single Room (upcharge applies)______ Double Room __x_ Share Room With: Lynelle Tucker