Identify Ministries Orientation, Confidentiality, & Release Forms
Please email us at Identifyministries@gmail.com if you have any questions about our ministry or about this form.

After completing this form, please use the link on the last section to schedule an orientation meeting with Derek Paul, our ministry director.
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Email *
Personal and Contact Information
Answer the following about yourself. Questions with a red star(*) beside it are required.
Please check the boxes that apply to you.
What is your full name? *
What is your age? *
Date of birth: *
MM
/
DD
/
YYYY
Your address (with city, state, and zip code):
Preferred phone number:
(If you don't have one, please type NONE)
 *
Your email address: *
Are you attending a church right now? *
If yes, what is the name of your church? (If no, input "N/A") *
Vocation:
Current living situation:
Reason for joining Identify Ministries?
Were you referred by anyone? If yes, who?
Name of your emergency contact? And what is your relationship with him/her?
(If you don't have one, type NONE)
 *
What is your emergency contact's phone number?
(If you don't have one, type NONE)
 *
Is there anything else we need to know about you?
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