Administration
Q1 Please enter the following:
First Name:

Last Name:

Telephone (W):

Telephone (H):

Telephone (C):

Telephone (F):

Address:

City:

State:

Zip Code:


Q2 Please enter the following:
Email:

Questions
Q3 Marital Status
Married
Widowed/Divorced (more than two years)
Single
Widowed or Divorced (less than two years)
Separated from Spouse

Q4 Are you a Word of Faith covenant member (completed all five new member classes)?
Yes
No

Q5 How long have you been a covenant member?
Less than 5 years
More than 5 years

Q6 Are you a consistent tither?
Yes
No

Q7 In how many Word of Faith ministries are you currently serving?
None
1 Ministry
2 Ministries
3 Ministries
4 or more Ministries


Bronner Ministerial Network
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