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
da_crump@yahoo.com

Q3. Gender



Q4. Please add your birthdate (MM/DD/YYYY):
11-21-1965

Q5. Residence History
ADDRESS CITY, STATE FROM: TO:
1 - 1506 Sage Ridge Drive
City:
Marietta
State:GA		 Month: 3
Day: 31
Year: 2006 		Month: 12
Day: 4
Year: 2014


Q6. Marital Status






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

Q8. If currently married, spouse's name:
Danielle Crump

Q9. If currently married, spouse's email address:
danc556@yahoo.com

Q10. If currently married, spouse's cell phone number:
404-775-2727

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 Organizationís Address, Zip Code Length of Service: Your Position: Ministry Name/Supervisor Phone Number: Did You Leave in Good Standing:
Foundations In Christianity Address: 212 Riverside Pkwy
Zip Code: 30168 		6 or more years Assistant Ministry Leader Ministry: Rev. Charles Blackshear
Phone: 678-410-2070		 Still Active
PUSH Address: 212 Riverside Pkwy
Zip Code: 30168 		6 or more years Ministry Servant Ministry: Deacon Dallas
Phone: 		Still Active
Altar Workers Address: 212 Riverside Pkwy
Zip Code: 30168 		6 or more years Ministry Leader Ministry: Cynthia Toliver
Phone: 678-427-7865		 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 stateís 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 WOF Ministers in Training program because I believe it is directly related to the call God has placed upon me. Furthermore I believe it will be an extension of my ministry as it is today, which is teaching the word of God and the importance of recognizing truth. I believe every spiritual gift must be practiced, developed, and this MIT training will help facilitate that. I came to WOF some eight years ago with ministerial licensing from my home church in New York. I have served as a minister previously but I realize the need to submit to the order of this house ñ meaning WOF, and simply follow the move of God. My desire is to serve and minister the gospel. I am doing that now in WOF, but outside as well. Wherever I find myself and opportunities are presented, I endeavor to plant a seed, to let people know of the awesome plan God has for their lives. I believe that through this program Iíll be more equipped to represent and deliver Godís word in a way that is relevant and effective for the days weíre living in. I believe there is a desperate need to show the world Godly ministers who use love as the impetus and guide for serving Godís people. No hidden agendas, just doing whatís right because itís the right thing to do. Finally, this program will allow me to more closely partner with WOF in our mission to ìReach the lost and teach the foundî; building Godís kingdom together.

Q30. First Name, Last Name
First Name:Derrick

Last Name: Crump

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?
Through Bethel Gospel Tabernacle Ministries (my New York City home church) under Bishop Roderick R. Caesar.

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)
N/A

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)
www.facebook.com/derrickcrumpGA

Q39. Do you have a LinkedIn account? If so, please provide it below. (http://www.linkedin.com/username)
https://www.linkedin.com/home?trk=nav_responsive_tab_home

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



Q41. Highest level of education?
Associates degree in Biblical Studies

Q42. Name, Location, and Years attended. (High School - College) (From: MM/YYYY-To: MM/YYYY)
SCHOOLíS NAME SCHOOLíS CITY, STATE FROM: TO: FIELD OF STUDY: DEGREE/DIPLOMA:
1 - South Florida Bible College & Theological Sem.
City: Deerfield Beach
State:
Associates		 Month: 1
Day:
Year: 2005
Month:7
Day:
Year: 2013
 2013 Biblical Studies
FL
2 - Borough of Manhattan Community
City: Manhattan
State:
 Month: 9
Day:
Year: 1984
Month:6
Day:
Year: 1987
 1987 Didn't complete degree
New York
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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):


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.
EMPLOYERíS NAME EMPLOYERíS CITY, STATE FROM: TO: JOB TITLE: SUPERVISORíS NAME/PHONE NUMBER: DESCRIBE YOUR WORK: REASON FOR LEAVING (IF APPLICABLE):
61 - Randstad IT staffing City:
Atlanta
State:
GA		 Month: 3
Day:
Year: 2013 		Month: 12
Day:
Year: 2014 		Network Engineer Hired as a consultant contracted to perform networking design, support and troubleshooting for Cox Communications.
62 - Principle Solutions IT staffing City:
Atlanta
State:
GA		 Month: 4
Day:
Year: 2012 		Month: 3
Day:
Year: 2013 		System Engineer Hired as a consultant contracted to perform system management, date center build-outs, application availability, and overall tuning and upgrading of critical systems at IHG. Better Job
63 - Pyramid IT staffing City:
Atlanta
State:
GA		 Month:
Day:
Year: 2010 		Month:
Day:
Year: 2012 		System Engineer Hired as a consultant contracted to implement enterprise wide packet capture solution and load balancing design and support at Delta Airlines corporate. Better Job
64 - F5 Networks City:
Atlanta
State:
GA		 Month: 7
Day:
Year: 2007 		Month: 9
Day:
Year: 2010 		Pre-sales engineer Hired to support the southeast sales team by presenting F5 technologies and capabilities to potential companies and lines of businesses, as well as educate current customers on capabilities and enhancements of products, Terminated
65 - Affiliated Computer Systems City:
Atlanta
State:
GA		 Month: 11
Day:
Year: 2006 		Month: 7
Day:
Year: 2007 		WebSphere admin Websphere Portal administrator Better Job
66 - E*TRADE Financial City:
Atlanta
State:
GA		 Month: 4
Day:
Year: 2006 		Month: 11
Day:
Year: 2006 		NOC engineer Hired to perform data center operations duties Better Job
67 - HSBC.com City:
Jersey City
State:
New Jersey		 Month:
Day:
Year: 2000 		Month:
Day:
Year: 2006 		Various roles but mostly System engineering such as UNIX, LINUX, system administration Hired to help build and support the HSBC bank online presence. Change in Location


Q48. First Name, Last Name
First Name:Derrick

Last Name: Crump

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 ORGANIZATIONíS CITY, STATE FROM: TO: YOUR POSITION: SUPERVISORíS NAME/PHONE NUMBER: DID YOU LEAVE IN GOOD STANDING:
81 - KCB (Keep Cobb Beautiful)
Marietta
State:
GA		 Month:
Day:
Year: 2012 		Month:
Day:
Year: Board member 		Board member Terrilyn Hannah Still Active
82 - Cobb Democrat Party
Cobb County
State:
GA		 Month:
Day:
Year: 2014 		Month:
Day:
Year: 		2014 District 1 Candidate Still Active


Q51. First Name, Last Name
First Name:Derrick

Last Name: Crump

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




Q53. At what age did you become a Christian baptized believer?
Approximately mid 20's

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.


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?
Achieved AA degree in Biblical Studies, on-going witnessing, attend conventions and training, self-study, support of ministry leaders, missions trips, be teachable.

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