Team 12/12 Mentoring

Please provide the following contact information:

**First Name
**Last Name
Middle Initial
**Street Address
Address (cont.)
**City
**State/Province
**Zip/Postal Code
Country
Mobile Phone
**Home Phone
**E-mail

Gender:

Female
Male

Marital Status:

Please select one Single Engaged Married Divorced

Is Jesus your savior and Lord?

Yes No

Have you been water baptized?

Yes No

Have you received the baptism of the Holy Spirit with the evidence of speaking in tongues?

Yes No

What best describes your relationship with the Lord?

Please select one Active and growing Inconsistent Newly committed

Please list two personal references:

First Name
Last Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Home Phone

First Name
Last Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Home Phone

Are you in a Christian community of God's choosing?

Yes No

If "Yes" to the answer above, what kind of community are you in?

Please select one Local Church Congregation Cell Church Home Church Emerging Church Community Business Church Cell/or Congregation Reformation/Apostolic Center

**What is your reason for wanting to become a Team 12/12 mentoree?

**Please complete the biographical information below including the following:

• Salvation experience
• Baptism of the Holy Spirit with the evidence of speaking in tongues
• Present relationship with the Lord including current prayer life
• God's election on your life to steward Kingdom finances
• His/your vision for this assignment

After you hit the "submit" button below you will be taken to an area to make your $50.00 application fee.  Your application is not complete until $50.00 payment is made.  Thank you.