Raw Score for this Application: 27 out of 59 - 45.7627118644% <br /><br/>Q1.   Please enter the following:   <br/><b> First Name:</b><input type="text" name="fname" value="Sarah" size="40" /><br/> <br />
                <b>Last Name:</b> <input type="text" name="lname" value="Ectle" size="40" /> <br/><br/>
                <b>Client ID#:</b> <input type="text" name="pat_id" value="380" size="40" /> <br/><br/>
               <!--- <b>Organization:</b> <input type="text" name="company" value="Link Construction System" size="40" /> <br/><br/>
                <b>Telephone (W):</b> <input type="text" name="phoneW" value="" size="40" /> <br/><br/>  -->
                <b>Telephone (H):</b> <input type="text" name="phoneH" value="787-8654-9922" size="40" /> <br/><br/>
                <b>Telephone (C):</b> <input type="text" name="phoneC" value="784-665-8872" size="40" /> <br/><br/>
           <!--     <b>Telephone (F):</b> <input type="text" name="phoneF" value="" size="40" /> <br/><br/>  -->
                <b>Address:</b> <input type="text" name="addressH" value="6564 Happy Street" size="40" /> <br/><br/>
                <b>City:</b><input type="text" name="cityH" value="Aiken" size="40" /> <br/><br/>
                <b>State or Province:</b>SC <br /> <br />
                <b>Postal Code:</b> <input type="text" name="zipH" value="29801" size="40" /> <br/><br/><br />Q2.  Please enter the following:   <br/> Email:<input type="text" name="email" value="Ectle" size="40" /><br/>  <br />Q3.   Marital Status  <br/><input type="radio" id="535" value="535" name="3" checked=""> <label for="535"> Married </label><br />
    <input type="radio" id="536" value="536" name="3" checked="checked"> <label for="536"> Widowed/Divorced (more than two years) </label><br />
    <input type="radio" id="537" value="537" name="3" checked=""> <label for="537"> Single  </label><br />
    <input type="radio" id="538" value="538" name="3" checked=""> <label for="538"> Widowed or Divorced (less than two years) </label><br />
    <input type="radio" id="539" value="539" name="3" checked=""> <label for="539"> Separated from Spouse </label><br />
    <br />Q4.  Are you a Word of Faith covenant member (completed all five new member classes)?  <br/><input type="radio" id="540" value="540" name="4" checked="checked"> <label for="540"> Yes </label><br />
    <input type="radio" id="541" value="541" name="4" checked=""> <label for="541"> No </label><br />
    <br />Q5. How long have you been a covenant member?  <br/><input type="radio" id="542" value="542" name="5" checked="checked"> <label for="542"> Less than 5 years </label><br />
    <input type="radio" id="543" value="543" name="5" checked=""> <label for="543"> More than 5 years  </label><br />
    <br />Q6. Are you a consistent tither?  <br/><input type="radio" id="544" value="544" name="6" checked="checked"> <label for="544"> Yes  </label><br />
    <input type="radio" id="545" value="545" name="6" checked=""> <label for="545"> No </label><br />
    <br />Q7.  In how many Word of Faith ministries are you currently serving?  <br/><input type="radio" id="546" value="546" name="7" checked=""> <label for="546"> None </label><br />
    <input type="radio" id="547" value="547" name="7" checked="checked"> <label for="547"> 1 Ministry </label><br />
    <input type="radio" id="548" value="548" name="7" checked=""> <label for="548"> 2 Ministries  </label><br />
    <input type="radio" id="549" value="549" name="7" checked=""> <label for="549"> 3 Ministries  </label><br />
    <input type="radio" id="550" value="550" name="7" checked=""> <label for="550"> 4 or more Ministries </label><br />
    <br />Q8. Please provide the following information for the last four (4) ministries in which you are/were involved:  <br/>
            
<table cellspacing="0" cellpadding="1" border="1"  id="CERT">
	<thead>
	<tr>
		<td>
		<b>NAME OF Ministry</b></td>
		<td>
		<b>How long were you apart of this ministry?:</b></td>
        	<td>
		<b>What role did you serve?:</b></td>

	</tr></thead><tbody> 
        

	<tr><td>Soup Kitchen</td>

		<td>
2-3 years </td>
		<td>
Ministry Servant </td>

	</tr>    
            

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