Ministry Trip Info Leave this field blank First Name Last Name Email Phone Mailing Address City State / Province ZIP Code / Postal Code Gender Choose Male Female Date of Birth Month January February March April May June July August September October November December Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034 2035 2036 2037 2038 2039 2040 Social Media Handle Personal History In the last 12 months, have you struggled with any of the following: smoking, drinking alcohol, illegal/non-perscription drugs, pornography, same-sex attraction, physical intimacy with someone other than your spouse? In the last 12 months, have you been arrested? Have you ever been involved in the occult, witchcraft or cults? Please describe any and all physical or emotional conditions and state any special attention, treatment or medication you require. Do you attend a local church? If so, what is the name of the church? Are you willing to provide two references, if requested? Ministry Trip Info Have you ever attended an event with Brandi ministering or attended any of her online classes? Choose Your Top 3 Areas of Ministry Focus Family & Marriage Intercession & Prayer Justice & Mercy Works Media & Technology Operations & Administration Outreach & Evangelism Pastoral Care & Community Life Speaking & Teaching Worship & Arts Youth Ministry Of the ministry areas chosen, which are you most passionate? Why? Explain what you feel called to do in this season. Anything else you think we should know? Send Info
