Q1.   Please enter the following:   <br/><b> First Name:</b><input type="text" name="fname" value="Gayle" size="40" /><br/> <br />
                <b>Last Name:</b> <input type="text" name="lname" value="Link" size="40" /> <br/><br/>
                <b>Client ID#:</b> <input type="text" name="pat_id" value="295" size="40" /> <br/><br/>
               <!--- <b>Organization:</b> <input type="text" name="company" value="" size="40" /> <br/><br/>
                <b>Telephone (W):</b> <input type="text" name="phoneW" value="66655453455" size="40" /> <br/><br/>  -->
                <b>Telephone (H):</b> <input type="text" name="phoneH" value="76554433" size="40" /> <br/><br/>
                <b>Telephone (C):</b> <input type="text" name="phoneC" value="65654433" size="40" /> <br/><br/>
           <!--     <b>Telephone (F):</b> <input type="text" name="phoneF" value="68686868" size="40" /> <br/><br/>  -->
                <b>Address:</b> <input type="text" name="addressH" value="6605 Ranklink" 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="Link" size="40" /><br/>  <br />Q3.   Marital Status  <br/><input type="radio" id="535" value="535" name="3" checked="checked"> <label for="535"> Married </label><br />
    <input type="radio" id="536" value="536" name="3" 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=""> <label for="542"> Less than 5 years </label><br />
    <input type="radio" id="543" value="543" name="5" checked="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>bbi2ytyt</td>

		<td>
1 year </td>
		<td>
Ministry Servant </td>

	</tr>    

	<tr><td>mntt4</td>

		<td>
2-3 years </td>
		<td>
Assistant Ministry Leader </td>

	</tr>    

	<tr><td>more</td>

		<td>
4-6 years </td>
		<td>
Assistant Ministry Leader </td>

	</tr>    
            

</tbody></table>         
           <br /><br />Q1. Have you completed Foundations in Christianity?  <br/><input type="radio" id="595" value="595" name="1" checked="checked"> <label for="595"> Yes  </label><br />
    <input type="radio" id="596" value="596" name="1" checked=""> <label for="596"> No </label><br />
    <br />Q2. Have you completed Foundations in Priesthood?  <br/><input type="radio" id="597" value="597" name="2" checked="checked"> <label for="597"> Yes </label><br />
    <input type="radio" id="598" value="598" name="2" checked=""> <label for="598"> No </label><br />
    <br />Q3.   Do you have a personal/ministry website? If so, please provide the web address. (Example: http://www.me.com)  <br/> <input type="text" name="3" value="http://hi.com" size="40" /><br/>
      <br />Q4.  Do you have a Twitter account?  If so, please provide it below. (http://www.twitter.com/yourtwittername)  <br/> <input type="text" name="4" value="Input" size="40" /><br/>
      <br />Q5.    Do you have a Facebook account?  If so, please provide it below.   (http://www.facebook.com/username)  <br/> <input type="text" name="5" value="Input" size="40" /><br/>
      <br />Q6.    Do you have a LinkedIn account?  If so, please provide it below.  (http://www.linkedin.com/username)  <br/> <input type="text" name="6" value="Input" size="40" /><br/>
      <br />Q7.   Do you have access to a computer for the completion of the MIT coursework?  <br/><input type="radio" id="603" value="603" name="7" checked="checked"> <label for="603"> Yes </label><br />
    <input type="radio" id="604" value="604" name="7" checked=""> <label for="604"> No </label><br />
    <br />Q8.     Highest level of education?  <br/>High School/GED<br/><br />Q9.  Name, Location, and Years attended. (High School) (From: MM/YYYY-To: MM/YYYY)  <br/>
            
<table 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 />Q10.   Do you have any licenses and/or certifications? (List Name, Date Certified, Expiration for each. )  <br/>
            
<table 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 />Q11. Have you ever been convicted of a crime?  <br/><input type="radio" id="613" value="613" name="11" checked=""> <label for="613"> Yes </label><br />
    <input type="radio" id="614" value="614" name="11" checked="checked"> <label for="614"> No </label><br />
    <br />Q12.   Do you have any pending litigation?  <br/><input type="radio" id="616" value="616" name="12" checked=""> <label for="616"> Yes </label><br />
    <input type="radio" id="617" value="617" name="12" checked="checked"> <label for="617"> No </label><br />
    <br />Q13.     If you answered yes to questions #11 and/or #12, please explain. (include year of conviction and/or pending litigation).  <br/>
                    <textarea rows="3" name="13" cols="50" style="margin-right: 40px; vertical-align: middle;"></textarea>
        <br /><br />Q14.   Have you ever served in the military?  <br/><input type="radio" id="618" value="618" name="14" checked="checked"> <label for="618"> Yes </label><br />
    <input type="radio" id="620" value="620" name="14" checked=""> <label for="620"> No </label><br />
    <br />Q15.    If you answered yes to question #14, in which branch did you serve? <br />(Ex. AIR FORCE, ARMY, NAVY, MARINES, COAST GUARD, NATIONAL GUARD)  <br/>
            
<table 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>

            

</tbody></table>         
            
           <br /><br />Q1.  Describe your work history?  <br/><input type="radio" id="621" value="621" name="1" checked="checked"> <label for="621"> Two or less jobs in the last five years </label><br />
    <input type="radio" id="622" value="622" name="1" checked=""> <label for="622"> Three jobs in the last five years </label><br />
    <input type="radio" id="623" value="623" name="1" checked=""> <label for="623"> Four or more jobs in the last five years </label><br />
    <br />Q2.  Add your work history for the last five (5) years  <br/>
            
<table 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>
            
            

</tbody></table>         
           <br /><br />Q1.    Are you active in your community (outside of church activities)?<br /><b>Community Involvement </b>  <br/><input type="radio" id="624" value="624" name="1" checked="checked"> <label for="624"> One or more community involvement(s) </label><br />
    <input type="radio" id="625" value="625" name="1" checked=""> <label for="625"> None  </label><br />
    <br />Q2.      If you indicated community involvement in question #1, we need further information.   <br/>
            
<table border="1" cellpadding="0" cellspacing="0"> <thead>
	
	<tr>
		<td>
		<b>NAME OF ORGANIZATION</b></td>
        <td>
		<b>ORGANIZATION’S CITY, STATE</b></td>
		<td>
		<b>FROM:</b></td>
		<td>
		<b>TO:</b></td>
		<td>
		<b>YOUR POSITION:</b></td>
		<td>
	   <b>	SUPERVISOR’S NAME/PHONE NUMBER:</b></td>
		<td>
		<b>DID YOU LEAVE IN GOOD STANDING:</b></td>
	</tr> </thead><tbody>
            
            

</tbody></table>         
           <br /><br />Q1. Are you a baptized Christian believer who has received the Holy Spirit?  <br/><input type="radio" id="661" value="661" name="1" checked=""> <label for="661"> Not Sure </label><br />
    <input type="radio" id="662" value="662" name="1" checked=""> <label for="662"> No </label><br />
    <input type="radio" id="663" value="663" name="1" checked="checked"> <label for="663"> Yes </label><br />
    <br />Q2. At what age did you become a Christian baptized believer?  <br/> <input type="text" name="2" value="Input" size="40" /><br/>
      <br />Q3.   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?  <br/><input type="radio" id="628" value="628" name="3" checked="checked"> <label for="628"> Yes </label><br />
    <input type="radio" id="629" value="629" name="3" checked=""> <label for="629"> No </label><br />
    <input type="radio" id="630" value="630" name="3" checked=""> <label for="630"> Not Sure </label><br />
    <br />Q4.  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?    <br/><input type="radio" id="631" value="631" name="4" checked="checked"> <label for="631"> Yes </label><br />
    <input type="radio" id="632" value="632" name="4" checked=""> <label for="632"> No </label><br />
    <input type="radio" id="633" value="633" name="4" checked=""> <label for="633"> Not Sure </label><br />
    <br />Q5.  Do you believe all have sinned and come short of the glory of God and are in need of salvation?  <br/><input type="radio" id="634" value="634" name="5" checked="checked"> <label for="634"> Yes </label><br />
    <input type="radio" id="635" value="635" name="5" checked=""> <label for="635"> No </label><br />
    <input type="radio" id="636" value="636" name="5" checked=""> <label for="636"> Not Sure </label><br />
    <br />Q6.  Do you believe that salvation of mankind comes only by confessing the Lord Jesus Christ and believing that God raised Him from the dead?  <br/><input type="radio" id="637" value="637" name="6" checked="checked"> <label for="637"> Yes </label><br />
    <input type="radio" id="638" value="638" name="6" checked=""> <label for="638"> No </label><br />
    <input type="radio" id="639" value="639" name="6" checked=""> <label for="639"> Not Sure </label><br />
    <br />Q7.  Do you believe in Jesus Christ’s bodily resurrection and ascension to the right hand of the Father in heaven?  <br/><input type="radio" id="640" value="640" name="7" checked="checked"> <label for="640"> Yes </label><br />
    <input type="radio" id="641" value="641" name="7" checked=""> <label for="641"> No </label><br />
    <input type="radio" id="642" value="642" name="7" checked=""> <label for="642"> Not Sure </label><br />
    <br />Q8.  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?  <br/><input type="radio" id="643" value="643" name="8" checked="checked"> <label for="643"> Yes </label><br />
    <input type="radio" id="644" value="644" name="8" checked=""> <label for="644"> No </label><br />
    <input type="radio" id="645" value="645" name="8" checked=""> <label for="645"> Not Sure </label><br />
    <br />Q9.  Do you believe in the deity, virgin birth, and perfect and sinless life of Jesus Christ?   <br/><input type="radio" id="646" value="646" name="9" checked="checked"> <label for="646"> Yes </label><br />
    <input type="radio" id="647" value="647" name="9" checked=""> <label for="647"> No </label><br />
    <input type="radio" id="648" value="648" name="9" checked=""> <label for="648"> Not Sure </label><br />
    <br />Q10.  Do you believe in the supernatural work of miracles and healing of Jesus Christ?  <br/><input type="radio" id="649" value="649" name="10" checked="checked"> <label for="649"> Yes </label><br />
    <input type="radio" id="650" value="650" name="10" checked=""> <label for="650"> No </label><br />
    <input type="radio" id="651" value="651" name="10" checked=""> <label for="651"> Not Sure </label><br />
    <br />Q11.  Do you believe in the substitutionary death of Jesus Christ and His bloodshed which atones for sins of the world?  <br/><input type="radio" id="652" value="652" name="11" checked="checked"> <label for="652"> Yes </label><br />
    <input type="radio" id="653" value="653" name="11" checked=""> <label for="653"> No </label><br />
    <input type="radio" id="654" value="654" name="11" checked=""> <label for="654"> Not Sure </label><br />
    <br />Q12.  Do you believe in the personal return of Jesus Christ in power and glory to rapture a mature church?      <br/><input type="radio" id="655" value="655" name="12" checked="checked"> <label for="655"> Yes </label><br />
    <input type="radio" id="656" value="656" name="12" checked=""> <label for="656"> No </label><br />
    <input type="radio" id="657" value="657" name="12" checked=""> <label for="657"> Not Sure </label><br />
    <br />Q13.  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?  <br/><input type="radio" id="658" value="658" name="13" checked="checked"> <label for="658"> Yes </label><br />
    <input type="radio" id="659" value="659" name="13" checked=""> <label for="659"> No </label><br />
    <input type="radio" id="660" value="660" name="13" checked=""> <label for="660"> Not Sure </label><br />
    <br />Q14.  Check all Five Fold Ministry positions to which you have been called.  <br/><input type="radio" id="673" value="673" name="24" checked=""> <label for="673"> Prophet </label><br />
    <input type="radio" id="674" value="674" name="24" checked=""> <label for="674"> Apostle </label><br />
    <input type="radio" id="675" value="675" name="24" checked=""> <label for="675"> Evangelist </label><br />
    <input type="radio" id="676" value="676" name="24" checked=""> <label for="676"> Pastor </label><br />
    <input type="radio" id="677" value="677" name="24" checked="checked"> <label for="677"> Teacher </label><br />
    <input type="radio" id="678" value="678" name="24" checked=""> <label for="678"> Other </label><br />
    <br />Q15. If you selected Other in the previous question  please explain.  <br/> <input type="text" name="25" value="Input" size="40" /><br/>
      <br />Q16.   Have you unconditionally made yourself available for whatever vocation God might want to use you?  <br/><input type="radio" id="664" value="664" name="26" checked="checked"> <label for="664"> Yes </label><br />
    <input type="radio" id="665" value="665" name="26" checked=""> <label for="665"> No </label><br />
    <br />Q17.  Are you willing to spend the necessary time preparing yourself to be effective in your calling?    <br/><input type="radio" id="666" value="666" name="27" checked="checked"> <label for="666"> Yes </label><br />
    <input type="radio" id="667" value="667" name="27" checked=""> <label for="667"> No </label><br />
    <br />Q18.    What have you done to prepare yourself for your calling?  <br/>
                    <textarea rows="3" name="28" cols="50" style="margin-right: 40px; vertical-align: middle;">Education</textarea>
        <br /><br />Q19. How many hours per week do you have to devote to a ministerial training and development program?  <br/><input type="radio" id="669" value="669" name="29" checked=""> <label for="669"> 0-3 hours </label><br />
    <input type="radio" id="670" value="670" name="29" checked=""> <label for="670"> 4-6 hours </label><br />
    <input type="radio" id="671" value="671" name="29" checked="checked"> <label for="671"> 7-10 hours </label><br />
    <input type="radio" id="672" value="672" name="29" checked=""> <label for="672"> 11-15 hours </label><br />
    <br />