Raw Score for this Application:  out of  - % <br /><br/>Q1. First Name, Last Name  <br/><b>Client:</b><br/> <br />
                <b>Division:</b>  <br/><br />Q2. Have you completed Foundations in Christianity at Word of Faith?  <br/><input type="radio" id="1995" value="1995" name="2" checked=""> <label for="1995">  Yes  </label><br />
    <input type="radio" id="1996" value="1996" name="2" checked=""> <label for="1996">  No  </label><br />
    <br />Q3. Have you completed Foundations in Priesthood at Word of Faith?  <br/><input type="radio" id="1997" value="1997" name="3" checked=""> <label for="1997">  Yes  </label><br />
    <input type="radio" id="1998" value="1998" name="3" checked=""> <label for="1998">  No  </label><br />
    <br />Q4. Have you ever been ordained or licensed as a pastor or minister?   <br/><input type="radio" id="2274" value="2274" name="18" checked=""> <label for="2274">  Yes  </label><br />
    <input type="radio" id="2275" value="2275" name="18" checked=""> <label for="2275">  No  </label><br />
    <br />Q5.    By what governing body are you currently licensed and/or ordained?   <br/>
                   
        <br /><br />Q6.   Do you have a personal/ministry website? If so, please provide the web address. (Example: http://www.me.com)  <br/> <br/>
      <br />Q7.   Do you have a Twitter account? If so, please provide it below. (http://www.twitter.com/yourtwittername)  <br/> <br/>
      <br />Q8.  Do you have a Facebook account? If so, please provide it below. (http://www.facebook.com/username)  <br/> <br/>
      <br />Q9.  Do you have a LinkedIn account? If so, please provide it below. (http://www.linkedin.com/username)  <br/> <br/>
      <br />Q10. Do you have access to a computer for the completion of the MIT coursework?  <br/><input type="radio" id="2003" value="2003" name="8" checked=""> <label for="2003">  Yes  </label><br />
    <input type="radio" id="2004" value="2004" name="8" checked=""> <label for="2004">  No  </label><br />
    <br />Q11. Highest level of education?   <br/> <br/>
      <br />Q12.  Name, Location, and Years attended. (High School - College) (From: MM/YYYY-To: MM/YYYY)  <br/>
            
<table width="700" border="1" cellpadding="1" cellspacing="0" ><thead>
	
	<tr>
		<td><b>SCHOOL’S NAME</b></td>
        <td>
		<b>SCHOOL’S CITY, STATE</b></td>
		<td>
		<b>FROM:</b></td>
		<td>
		<b>TO:</b></td>
		<td>
		<b>FIELD OF STUDY:</b></td>
		<td>
	   <b>	DEGREE/DIPLOMA:</b></td>
	</tr> </thead><tbody>
            
            

</tbody></table>         
           <br /><br />Q13. Do you have any licenses and/or certifications? (List Name, Date Certified, Expiration for each.)  <br/>
            
<table width="700" id="CERT" border="1" cellpadding="1" cellspacing="0" ><thead>
	
	<tr>
		<td >
		<b>NAME OF CERTIFICATION</b></td>
		<td >
		<b>DATE CERTIFIED/LICENSED:</b></td>
        	<td >
		<b>EXPIRATION (IF APPLICABLE):</b></td>

	</tr> </thead><tbody>
            
            </tbody>

</table>         
           <br /><br />Q14. Have you ever worked for the armed forces?  <br/><input type="radio" id="2014" value="2014" name="15" checked=""> <label for="2014">  Yes  </label><br />
    <input type="radio" id="2015" value="2015" name="15" checked=""> <label for="2015">  No  </label><br />
    <br />Q15. If you answered yes to question #14, in which branch did you serve? (Ex. AIR FORCE, ARMY, NAVY, MARINES, COAST GUARD, NATIONAL GUARD)  <br/>
            
<table width="700" cellspacing="0" cellpadding="1" border="1"   id="MILT"><thead>
	
	<tr>
		<td>
		<b>NAME BRANCH OF SERVICE</b></td>

       <td>
		<b>HIGHEST RANK</b></td>

		<td>
		<b>DATE ENTERED:</b></td>

	<td>
		<b>DATE DISCHARGED:</b></td>

		<td> 
		<b>TYPE OF DISCHARGED:</b></td>

		<td>
	   <b>	DD214 NUMBER:</b></td>

	</tr> </thead><tbody>


	<tr>
		<td>
	  <b> 1</b> - </td>
  


 	<td>
	 </td>

		<td>


 Month:   <br />

Day: <br />

Year: 

</td>
		<td>

Month:<br />

Day: <br />

Year: </td>
  	<td>

    
       </td>
	<td>
	  </td>

	</tr>    
            

</tbody></table>         
            
           <br /><br />Q16. Describe your work history?   <br/><input type="radio" id="2285" value="2285" name="21" checked=""> <label for="2285">  One or two jobs in the last five years   </label><br />
    <input type="radio" id="2286" value="2286" name="21" checked=""> <label for="2286">  Three jobs in the last five years   </label><br />
    <input type="radio" id="2287" value="2287" name="21" checked=""> <label for="2287">  Four or more jobs in the last five years   </label><br />
    <input type="radio" id="2288" value="2288" name="21" checked=""> <label for="2288">  No job in the last five years because of retirement  </label><br />
    <input type="radio" id="2289" value="2289" name="21" checked=""> <label for="2289">  No job in the last five years because of physical restrictions or mental illness  </label><br />
    <input type="radio" id="2290" value="2290" name="21" checked=""> <label for="2290">  No job for other reasons  </label><br />
    <br />Q17. Work History: Please list the last 10 years.   <br/>
            
<table width="700" border="1" cellpadding="0" cellspacing="0"><thead>
	
	<tr>
		<td>
		<b>EMPLOYER’S NAME</b></td>
        <td>
		<b>EMPLOYER’S CITY, STATE</b></td>
		<td>
		<b>FROM:</b></td>
		<td>
		<b>TO:</b></td>
		<td>
		<b>JOB TITLE:</b></td>
		<td>
	   <b>	SUPERVISOR’S NAME/PHONE NUMBER:</b></td>
		<td>
		<b>DESCRIBE YOUR WORK:</b></td>
		<td>
		<b>REASON FOR LEAVING (IF APPLICABLE):</b></td>
	</tr> </thead><tbody>
            

	<tr>
		<td>
	 <b> 61</b> - </td>

   


      	<td>
	City: <br /><br />

       State:<br/> </td>

		<td>

 Month:  <br />

Day: 
       <br />

Year: 

</td>
		<td>

Month:	  <br />

Day: <br />

Year: 

 </td>
		<td>
	   </td>
		<td>
	   </td>
		<td>
		</td>
		<td>
     </td>
	</tr>    
            

</tbody></table>         
           <br /><br />