Raw Score for this Application: out of - %

Q1. Please enter the following: Name, Address, Phone Numbers, Organization
Client:

Division:

ID#:

Telephone (W):

--> Telephone (H):

Telephone (C):

Address:

City:

State or Province:

Postal Code:

Q2. Please enter your email address

Q3. Gender
Female
Male

Q4. Please add your birthdate (MM/DD/YYYY):

Q5. Residence History

ADDRESS	CITY, STATE	FROM:	TO:
1 -	City: State:	Month: Day: Year:	Month: Day: Year:

Q6. Marital Status
Married
Widowed/Divorced (more than two years)
Single
Widowed or Divorced (less than two years)
Separated from Spouse

Q7. If married, divorced, separated, or widowed, how long?

Q8. If currently married, spouse's name:

Q9. If currently married, spouse's email address:

Q10. If currently married, spouse's cell phone number:

Q11. Are you a Word of Faith covenant member (completed all five new member classes)?
Yes
No

Q12. How long have you been a covenant member?
Less than 5 years
More than 5 years

Q13. Are you a consistent tither?
Yes
No

Q14. In how many Word of Faith ministries are you currently serving?
None
1 Ministry
2 Ministries
3 Ministries
4 or more Ministries

Q15. Please provide the following information for up to four (4) ministries (WOF & non-WOF) in which you are/were involved:

Name of Organization	Organization’s Address, Zip Code	Length of Service:	Your Position:	Ministry Name/Supervisor Phone Number:	Did You Leave in Good Standing:

Q16. Have you ever been convicted of a Felony?
Yes
No

Q17. If yes, please explain.

Q18. Have you ever been convicted of a Misdemeanor?
Yes
No

Q19. If yes, please explain.

Q20. Have you ever been or received First Offender's status for a crime?
Yes
No

Q21. If yes, please explain.

Q22. Are you listed on any state
Yes
No

Q23. If answered yes above, please list the states in which you are registered:

States

Q24. Have you ever been addicted to drugs or alcohol?
Yes
No

Q25. Are you currently clean and sober?
Yes
No

Q26. Would you be willing to submit to drug/alcohol testing?
Yes
No

Q27. If not please explain.

Q28. How many years of ministerial experience (Five-Fold Ministry Service) do you have?
0 to 5 Years
5 to 10 Years
10 Plus Years

Q29. Please describe why you want to be a part of this program. The essay should be at least a total of 250 words.