Name *

First Name

Last Name

Phone *

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Birthday: Ex. 09/26/2000 *

MM

DD

YYYY

Reference 1 *

First Name

Last Name

Phone

(###)

###

####

Relationship

Professional

Personal

Reference 2 *

First Name

Last Name

Phone *

(###)

###

####

Relationship *

Professional

Personal

I believe that Jesus Christ was born of a virgin. *

Agree

Disagree

I believe the miracles were supernatural occurrences as presented in the Biblical account . *

Agree

Disagree

I believe in the literal resurrection of Jesus Christ. *

Agree

Disagree

I believe because God gives eternal life through Jesus Christ, believers are secure in their salvation for eternity. Salvation is maintained by the grace and power of God, not by a Christian’s self-effort. *

Agree

Disagree

I believe the Bible is without error in its original form. *

Agree

Disagree

I believe the Father, Son and Holy Spirit are three persons but one God. *

Agree

Disagree

I believe the practicing of “charismatic gifts' ' (i.e. speaking in tongues, interpreting tongues, etc.) are to be practiced only in accordance with orderly worship as presented in scripture (1 Cor 12). *

Agree

Disagree

I believe in the priesthood of the believer, that all Christians have direct access to God. *

Agree

Disagree