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

Last Name:

Client ID#:

Telephone (H):

Telephone (C):

Address:

City:

State or Province:GA

Postal Code:


Q2. Please enter your email address
jstephenpalmer@gmail.com

Q3. Gender



Q4. Please add your birthdate (MM/DD/YYYY):
02-18-1985

Q5. Residence History
ADDRESS CITY, STATE FROM: TO:
1 - 585 Watson Bay Trail
City:
Stone Mountain
State:Georgia		 Month: 1
Day: 1
Year: 2010 		Month: 1
Day: 1
Year: 2015
2 - 1484 Cain Court North
City:
Douglasville
State:Georgia		 Month: 12
Day: 7
Year: 2007 		Month: 1
Day: 1
Year: 2010


Q6. Marital Status






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

Q8. If currently married, spouse's name:
N/A

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

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

Q11. Are you a Word of Faith covenant member (completed all five new member classes)?



Q12. How long have you been a covenant member?



Q13. Are you a consistent tither?



Q14. In how many Word of Faith ministries are you currently serving?






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:
New Generation Youth Address: 829 Hollywood Road Atlanta, Georgia
Zip Code: 30318 		1 year Ministry Leader Ministry: Generations Outreach Ministries
Phone: 4044478179		 Still Active
Word of Faith CEO Ministry Address: 212 Riverside Parkway, Austell, Georgia
Zip Code: 30168 		4-6 years Ministry Servant Ministry: Rev. Charles Blackshear
Phone: 6784102070		 Still Active
Word of Faith Youth Ministry Address: 212 Riverside Parkway Austell, Georgia
Zip Code: 30168 		Less than 1 year Ministry Servant Ministry: Pastors Kirstie and Kristie Bronner
Phone: 7708748400		 Did Not Leave in Good Standing
On Tha S.P.O.T. Bible Study new name: The Conversations Address: 585 Watson Bay Trail Stone Mountain, Georgia
Zip Code: 30087 		2-3 years Ministry Leader Ministry: Stephen J. Palmer
Phone: 678.702.2445		 Still Active


Q16. Have you ever been convicted of a Felony?



Q17. If yes, please explain.
N/A

Q18. Have you ever been convicted of a Misdemeanor?



Q19. If yes, please explain.
N/A

Q20. Have you ever been or received First Offender's status for a crime?



Q21. If yes, please explain.
N/A

Q22. Are you listed on any state’s Lifetime Sex Offender Registry?



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?



Q25. Are you currently clean and sober?



Q26. Would you be willing to submit to drug/alcohol testing?



Q27. If not please explain.
N/A

Q28. How many years of ministerial experience (Five-Fold Ministry Service) do you have?




Q29. Please describe why you want to be a part of this program. The essay should be at least a total of 250 words.
I desire to participate in the Word of Faith Ministers in Training Program because I want to adequately, efficiently and effectively pour into the lives of the individuals that I touch within my ministry and on a daily basis. My vision in life is to “Inspire People to know God and fulfill their purpose.” Each day as I live out this purpose, I find that people in church and un-churched are hungry and longing to receive real examples of Christ in everyday life. They are searching to find the truth not only in the Bible, but in people who call themselves Christians. WOF MIT Program will give me a deliberate, consistent and disciplined vehicle to sharpen me, not only in the practical lessons in ministry, but help to shape me to be a ministry leader that is formed in the image of Jesus Christ. I have a passion and desire to be made in the image of Christ, so that I can teach, preach, and reach those who are lost and disciple those who are found. I have been in church all my life, been involved in world-recognized ministries and have known that I am called to ministry; now I know is the time to properly prepare so that I can be counted worthy of my calling and fulfill all that God has designed me be; to take back this city, state, nation and world for Jesus Christ. I will study to show myself approved and allow the Word to examine my life. I will be committed in pursuit of my call to show those who are searching for truth the Light as a WOF MIT participant.

Q30. First Name, Last Name
First Name:Stephen

Last Name: Palmer

Q31. Have you completed Foundations in Christianity at Word of Faith?



Q32. Have you completed Foundations in Priesthood at Word of Faith?



Q33. Have you ever been ordained or licensed as a pastor or minister?



Q34. By what governing body are you currently licensed and/or ordained?


Q35. Are you seeking licensing and/or ordination from MIT?



Q36. Do you have a personal/ministry website? If so, please provide the web address. (Example: http://www.me.com)
www.jstephenpalmer.com

Q37. Do you have a Twitter account? If so, please provide it below. (http://www.twitter.com/yourtwittername)
N/A

Q38. Do you have a Facebook account? If so, please provide it below. (http://www.facebook.com/username)
N/A

Q39. Do you have a LinkedIn account? If so, please provide it below. (http://www.linkedin.com/username)
www.linkedin.com/pub/stephen-palmer/24/b60/9b/

Q40. Do you have access to a computer for the completion of the MIT coursework?



Q41. Highest level of education?
Associates Degree

Q42. Name, Location, and Years attended. (High School - College) (From: MM/YYYY-To: MM/YYYY)
SCHOOL’S NAME SCHOOL’S CITY, STATE FROM: TO: FIELD OF STUDY: DEGREE/DIPLOMA:
1 - Stephenson High School
City: Stone Mountain
State:
Dual Technical and Career Diploma		 Month: 1
Day:
Year: 2000
Month:5
Day:
Year: 2003
 2003 High School Education
Georgia
2 - Georgia Perimeter College
City: Clarkston
State:
Associates of Science		 Month: 1
Day:
Year: 2012
Month:5
Day:
Year: 2012
 2012 Business Administration
Georgia
3 - Georgia Southwestern State University
City: Americus
State:
Bachelors of Science		 Month: 5
Day:
Year: 2012
Month:5
Day:
Year: 2015
 2015 Business Administration Management
Georgia
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Q43. Do you have any licenses and/or certifications? (List Name, Date Certified, Expiration for each.)
NAME OF CERTIFICATION DATE CERTIFIED/LICENSED: EXPIRATION (IF APPLICABLE):
Georgia Crime Information Center Operator Month: 4
Day:
Year: 2007
Month:4
Day:
Year: 2012
GA General Mediation Certification Month: 6
Day:
Year: 2007
Month:6
Day:
Year: 2009
GA P.O.S.T.-Basic Law Enforcement Month: 4
Day:
Year: 2008
Month:
Day:
Year:
Detention & Removal Operations Basic Federal Law Enforcement Training Month: 12
Day:
Year: 2010
Month:
Day:
Year:
Basic Supervisory & Management Training Month: 5
Day:
Year: 2011
Month:
Day:
Year:
Certificate of Appointment of Notary Public Month: 7
Day:
Year: 2013
Month:7
Day:
Year: 2017


Q44. Have you ever worked for the armed forces?



Q45. If you answered yes to question #14, in which branch did you serve? (Ex. AIR FORCE, ARMY, NAVY, MARINES, COAST GUARD, NATIONAL GUARD)
NAME BRANCH OF SERVICE HIGHEST RANK DATE ENTERED: DATE DISCHARGED: TYPE OF DISCHARGED: DD214 NUMBER:
1 - Month:
Day:
Year: 		Month:
Day:
Year:


Q46. Describe your work history?







Q47. Work History: Please list the last 10 years.
EMPLOYER’S NAME EMPLOYER’S CITY, STATE FROM: TO: JOB TITLE: SUPERVISOR’S NAME/PHONE NUMBER: DESCRIBE YOUR WORK: REASON FOR LEAVING (IF APPLICABLE):
61 - Secure America, LLC City:
Atlanta
State:
Georgia		 Month: 6
Day:
Year: 2014 		Month: 11
Day:
Year: 2014 		Security Shift Manager Tony Forde, 404.926.4259 • Responsible for managing a team of security personnel and coordinating with property management, facilities and custodial engineers, to ensure the nightly protection of a 20-story, 500,000 sq. foot property, its assets, and tenants located in Buckhead Atlanta. Terminated
62 - Visionary Construction, LLC City:
Atlanta
State:
Georgia		 Month: 6
Day:
Year: 2014 		Month: 10
Day:
Year: 2014 		Project Administrator/Manager & Consultant Tasha Reid, 678.913.8337 • Provide consultation services to businesses in the areas of strategic planning, infrastructure design and strategy implementation. Short-Term
63 - Georgia House Representative-District 62 City:
Atlanta
State:
Georgia		 Month: 1
Day:
Year: 2013 		Month: 4
Day:
Year: 2014 		Chief of Staff Representative LaDawn B. Jones, 404.343.6770 Managed a staff of college interns, part-time volunteers, and full-time employees; Screened resume's, conducted interviews, supervised completion of assigned tasks, scheduled work days and trained all personnel through self created proprietary training system; Applied meticulous attention to detail
64 - LBJ Law Group, LLC City:
Atlanta
State:
Georgia		 Month: 1
Day:
Year: 2013 		Month: 4
Day:
Year: 2014 		Legal Assistant & Office Manager LaDawn B. Jones, 404.343.6770 Sustained office efficiency by planning and implementing office systems, layouts, and equipment procurement; Coordinated vendors, witnesses, opposing counsel, employees, and client schedules for court, mediation and/or other legal activities. Designed and employed office policies by establishing sta
65 - Fulton County Sheriff's Department City:
Atlanta
State:
Georgia		 Month: 1
Day:
Year: 2012 		Month: 7
Day:
Year: 2013 		Deputy Sheriff & Special Operations Response Team Member Sgt. Reese, 404.612.5100 Supervised over 150 inmates safety, security, and order on the Maximum Security Inmate Housing floor; Trusted with high level confidential information; Documented collected information from observations, interviews and i-witness accounts; Participated in tactical planning, executions, and debriefin Change in Location
66 - Fulton County Marshal's Department City:
Atlanta
State:
Georgia		 Month: 6
Day:
Year: 2006 		Month: 9
Day:
Year: 2009 		Marshal Deputy I (GCIC Operator & Record & Document Specialist) Captain Frank Wildy, 404.612.4451 Quickly resolved high-stress situations through law enforcement protocols; accurately verified documents for case sensitive and confidential information through monthly evaluations and periodic system checks to insure departmental compliance; preserved the safety, order and proper execution of the Better Job
67 - Macy's South City:
Decatur
State:
Georgia		 Month: 12
Day:
Year: 2004 		Month: 8
Day:
Year: 2006 		Team Captain Rhonda McKay, 404.329.2600 Supervised department employees, handled scheduling, training, and motivating cross-selling within department; Managed stock levels, new inventory shipments, delivery and making key decisions about stock control; Analyzed the sales floor regularly to insure proper setup to corporate grids; spoke to Better Job


Q48. First Name, Last Name
First Name:Stephen

Last Name: Palmer

Q49. Are you active in your community (outside of church activities)?



Q50. If you indicated community involvement in question #1, we need further information.
NAME OF ORGANIZATION ORGANIZATION’S CITY, STATE FROM: TO: YOUR POSITION: SUPERVISOR’S NAME/PHONE NUMBER: DID YOU LEAVE IN GOOD STANDING:
81 - Generations Outreach Inc.
Atlanta
State:
Georgia		 Month: 3
Day:
Year: 2013 		Month:
Day:
Year: New Generation Youth Mentor Board Member and Advisor 		New Generation Youth Mentor Board Member and Advisor Ryan Dunn, 678.612.3829 Still Active
82 - Women of Westlake
Atlanta
State:
Georgia		 Month: 3
Day:
Year: 2004 		Month:
Day:
Year: Keynote Speaker & Big Brother 		Keynote Speaker & Big Brother LaDawn Jones, 404.343.6770 Still Active
83 - Elite Talent Sports Foundation
Atlanta
State:
Georgia		 Month: 3
Day:
Year: 2014 		Month:
Day:
Year: Consultant and Business Advisor 		Consultant and Business Advisor Derrick Tatum, 404.226.8526 Still Active


Q51. First Name, Last Name
First Name:Stephen

Last Name: Palmer

Q52. Are you a baptized Christian believer who has received the Holy Spirit?




Q53. At what age did you become a Christian baptized believer?
10

Q54. Do you believe that the Holy Bible (Old and New Testaments) is the inspired, inerrant and only infalliable, authoritative word of God and the final authority in faith and conduct?




Q55. Do you believe there is only one true God, eternally existent and manifested in the triune Godhead, three persons equal in power and purpose and authority: God the Father, God the Son (Jesus Christ) and God the Holy Spirit?




Q56. Do you believe all have sinned and come short of the glory of God and are in need of salvation?




Q57. Do you believe that salvation of mankind comes only by confessing the Lord Jesus Christ and believing that God raised Him from the dead?




Q58. Do you believe in Jesus Christ's bodily resurrection and ascension to the right hand of the Father in heaven?




Q59. Do you believe in the resurrection of the dead to either eternal life with Jesus for the saved or eternal damnation in hell for the unbelieving lost?




Q60. Do you believe in the deity, virgin birth, and perfect and sinless life of Jesus Christ?




Q61. Do you believe in the supernatural work of miracles and healing of Jesus Christ?




Q62. Do you believe in the substitutionary death of Jesus Christ and His bloodshed which atones for sins of the world?




Q63. Do you believe in the personal return of Jesus Christ in power and glory to rapture a mature church?




Q64. Do you believe in the observance of the Eucharist (Holy Communion) and in the ministry and baptism of the Holy Spirit, empowering and enabling the Christian to live a holy life in this present world and to minister as Jesus ministered?




Q65. Check all Five Fold Ministry positions to which you have been called.







Q66. If you selected Other in the previous question please explain.
Administrative

Q67. Have you unconditionally made yourself available for whatever vocation God might want to use you?



Q68. Are you willing to spend the necessary time preparing yourself to be effective in your calling?



Q69. What have you done to prepare yourself for your calling?
I have prayed, fasted and studied the Word. I have surrounded myself with mentors who are Holy Spirit led and have wisdom in various folds in the ministry. I have sat in some classes and taken personal self educated course via online access, various curriculum and study material.

Q70. How many hours per week do you have to devote to a ministerial training and development program?