First Name:  * Last Name:  * Email Address: Address:  * City:  * State: Zip Code: Date of Birth  * Home Telephone:  * Business Phone Cell Phone   Martial Status: SINGLEMARRIEDDIVORCEDWIDOW/WIDOWEROTHER Are you a citizen of the USA?  * In what year were you saved? (Born again)  * Ministry Name  *   Do you believe in and have you received the Baptism of the Holy Ghost?  * Do you believe the Gifts of the Spirit are operational today as with the first church?  * Are you affiliated with any ministerial group fellowship or organization?  * If you answer yes to the abo ve question please give name Are you acquainted with any member of GMCI? If yes please give name  * Do you currently have any criminal or civil lawsuits pending againt you? If yes give summary statement.  *   Have you or any member of your staff ever been convicted of a felony including child abuse molestation or spousal abuse? If yes give summary statement  *   Do you use any of the following? TobaccoAlcoholic BeveragesIllegal drugsI DO NOT USE ANY OF THE ABOVE If you use any of the above give summary What is your belief concerning the homosexual lifestyle? God does not objectGod does not approveI have no opinion   Please type your name again to confirm all the above information is true to the best of your knowledge.  * Security code:   * Do not enter anything in this field: