GODLY MAN STUDY GROUP
REGISTRATION INFORMATION FORM

    God has a wonderful purpose for your life.  We want to help you find and fulfill that purpose.
The following information will enable us to do that more effectively.
Please fill out the form as completely as possible.

     Date: 

     First Name: 
     Middle Name: 
     Nick Name (if any): 
     Last Name: 

     Street Address: 
     Address Line 2: 
     City:  State:  Zip Code: 
          Home Phone:  Work Phone: 
     Cell Phone:    Beeper: 
     FAX:  E-mail: 

    
Birth date  Age 

     What is your marital status?
 Single  Married  Separated  Divorced

     If married, please give your spouses name. 
         Please give the name, gender, and age of your children.

    EDUCATION BACKGROUND: List your education (secular and religious) beginning with the      highest degree.
    Be sure to include any discipleship or ministry training you've had through churches or
    ministries.  Please give the name of the school, location, and date(s) you attended or
    earned your degree.

 

    WORK BACKGROUND:  Beginning with latest job, please list the last four places you've
    worked.  Be sure and include ministry experience. Please give the dates of employment,
    employer, employer's address, and position held.

     REFERENCES: Give three Christian references (people who know your walk with the Lord).
     Please give their name, address, and years known.

     SPECIAL SKILLS: List special skills you have (sewing, cooking, carpentry, plumbing, etc.)

      What do you hope to receive from the study group?

       Do you have an audiocassette or CD player? (please indicate which one) 

     Do you have regular access to a computer and know how to use it? 

     Do you have regular access to the internet? 

     What word processing program does your computer use? 

    We would like to get to know you better.  Please enclose a copy of yourpersonal                   testimony in 500 words or less, telling of your life before you were saved, how you                found Jesus, and your life as a Christian. 

NOTE: If your computer is not set up to allow Emails to be sent from it this form will not go                            through.  Also, please be sure it doesn’t get stuck in your outbox.