Familiarization Form

Name *

Name

First

Last

Address *

Kindly ensure the address includes your country and the state in the country.

Date of Birth (dd/mm/yyyy) *

Email *

WhatsApp Line *

Country *

Name of previous Church *

Why did you leave your previous Church? *

What position were you holding in your previous Church? (if none, kindly indicate "none") *

Gender *

Male

Female

Marital Status *

Married

Divorced

Widow/Widower

Single/engaged

Single/searching

Department *

Children (Age 0-12)

Teenager (Age 13-19)

Youth (20 - Married)

Men (Married)

Women (Married)

How many biological children do you have? (if none yet, kindly indicate "None") *

Are you born again? *

Yes

No

When did you get born again? *

Are baptised in the Holy Ghost with the evidence of speaking in tongues? *

Yes

No

If you are human, leave this field blank.