Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Birthday Day

MM

DD

YYYY

Spouse's Name (if applicable) *

First Name

Last Name

Have you been born again? *

Yes

No

Have you been baptized in water by immersion? *

Yes

No

Have you Received baptism in the Holy Spirit with initial physical evidence of tongues? *

Yes

No

Do you sense a call to ministry and can you articulate it? *

Yes

No

Completed Education *

Please choose where you have had formal bible training. If you are newly enrolled, please let us know the date you plan on completing your ministry program training.

AG College/University

Berean/Global University Online

TSOM

Newly Enrolled in Bible Courses

Other

Are you Married? *

Yes

No

Do you or your spouse have a former spouse still living? *

Yes

No

Have you ever declared bankruptcy? *

Yes

No

Do you have any felony or misdemeanor charges on your record? *

Yes

No