Program Enrolling (Select) *Ministry Training ProgramCertificate in Christian Service Associate Diploma in Christian ServiceDiploma in Christian Service

Name *

First

Last

Sex *

• Male
• Femal

Age *

Phone Contact

Email *

Address *

Marital Status *SingleMarriedDivorced/SeparatedSingle ParentRe-MarriedWidowWidower

Occupation *

Which year did you get saved? *

Which year did you get water baptized? *

Which year did you get filled in the Spirit? *

Do you speak in tongues? *

Have you completed Foundations 1 and 2? *

• Yes
• No

What level of CDP are currently doing? *NoneLevel OneLevel TwoLevel ThreeLevel FourLevel FiveLevel Six

Name the Church you attend? *

What ministry role or function are you involved in? *

What is the name of your Pastor? *

Are you able pay ATC fees? *

• Yes
• No

Are you a UAOG credential holder? *

• Yes
• No

Level of EducationNoneP.L.EUOSEUASETertiary/CollegeUniversityNone

Are you able to read and write in English?YesNo

Do you have any known sickness? *

• Yes
• No

Name the sickness...

Name

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