Leader Application

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

Country

(###)

###

####

Social Media

Please list what type and your account name.

Age

Birthdate

YYYY

Sex

Marital Status

When did you become a believer in Jesus Christ?

Tell us about your salvation experience.

Have you been water baptized?

Have you been baptized in the Holy Spirit with the evidence of speaking in tongues?

In what skills or trade are you qualified?

Please list below

Indicate any languages you know (other than English) and state your proficiency as Good, Fair or Poor.

Do you have any Christian ministry leadership experience?

If yes, please explain what ministry you were with and for how long.

Have you participated in an international or urban outreach?

If yes, please explain.

Have you lead an international or urban outreach?

If yes, please explain.

Have you participated in disaster relief work?

If yes, please explain.

I hereby certify that I have verified all the information given above is true and correct.

I certify by checking this as my digital signature.

Current Date

YYYY

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