Raw Score for this Application:  out of  - % <br /><br/>Q1. Please enter the following: First Name, Last Name  <br/><b>First Name:</b><input type="text" name="fname" value="" size="40" /><br/> <br />
                <b>Last Name:</b> <input type="text" name="lname" value="" size="40" /> <br/><br />Q2. Ministry and Community Involvement  <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> 
        
            

</tbody></table>         
           <br /><br />Q3.   Did you leave in good standing?   <br/><input type="radio" id="1394" value="1394" name="3" checked=""> <label for="1394"> Yes </label><br />
    <input type="radio" id="1395" value="1395" name="3" checked=""> <label for="1395"> No </label><br />
    <br />Q4. If your answer is no, please provide supporting details.  <br/>
                    <textarea rows="3" name="4" cols="50" style="margin-right: 40px; vertical-align: middle;"></textarea>
        <br /><br />Q5.  How would you describe your OVERALL personal financial status? (We will pull your credit report as part of our background check process, should you choose to go through the church planting process with Christian Alliance of Pastors, Inc.)  <br/><input type="radio" id="1397" value="1397" name="5" checked=""> <label for="1397"> Excellent </label><br />
    <input type="radio" id="1398" value="1398" name="5" checked=""> <label for="1398"> Good </label><br />
    <input type="radio" id="1399" value="1399" name="5" checked=""> <label for="1399"> Poor </label><br />
    <br />Q6. Have you filed for bankruptcy within the last 10 years?   <br/><input type="radio" id="1400" value="1400" name="6" checked=""> <label for="1400"> Yes </label><br />
    <input type="radio" id="1401" value="1401" name="6" checked=""> <label for="1401"> No </label><br />
    <br />Q7. If yes, explain.  <br/> <input type="text" name="7" value="" size="40" /><br/>
      <br />Q8. Are there any liens or judgments pending against you?   <br/><input type="radio" id="1403" value="1403" name="8" checked=""> <label for="1403"> Yes </label><br />
    <input type="radio" id="1404" value="1404" name="8" checked=""> <label for="1404"> No </label><br />
    <br />Q9. If yes, explain  <br/> <input type="text" name="9" value="" size="40" /><br/>
      <br />Q10. What are your total assets?  <br/> <input type="text" name="10" value="" size="40" /><br/>
      <br />Q11. What are your total liabilities (include your total mortgage amount)?  <br/> <input type="text" name="11" value="" size="40" /><br/>
      <br />Q12.   What is your net worth (Total assets - Total liabilities)?   <br/> <input type="text" name="12" value="" size="40" /><br/>
      <br />