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?
Your answer
Email of Nominee
Your answer
Phone Number of Nominee
Your answer
Please write a brief summary of your reason(s) for nominating this person.
Your answer
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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