Licensed Ministry Referral Form
I believe the following person meets most of the expectations of this ministry and would like to learn more about it.
Name *
First and Last Name
Your answer
Address *
Your answer
Address Line 2
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City *
Your answer
State *
Your answer
Zip Code *
Your answer
Email *
Your answer
Phone number *
Your answer
Church They Are a Member Of *
Your answer
Number of Years They Have Been a Member *
In what capacity has this nominee served his or her local church or the Northern Plains Conference? *
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Email of Nominee *
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Phone Number of Nominee *
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Please write a brief summary of your reason(s) for nominating this person. *
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Referring Pastor *
First and Last Name
Your answer
Referring Pastor's Church *
Your answer
Referring Pastor's E-mail *
Your answer
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