First Pentecostal Power Ministries Worldwide

2006/2007 Pastors and Church Workers International Retraining Conference

Participation Form                                                                         P. O. Box 40916, Raleigh, NC 27629

December 1, 2006 - June 30, 2007                                                          P.O. Box 3018, Apapa, Lagos, Nigeria

FOR OFFICE USE:

Instructions: Print this form. Complete and mail it to either of the above addresses, or submit by hand to your regional office, or copy the questions and send the answers as MS Word attachment to fppf@firstpentecostal.org, frankfreds@firstpentecostal.org or your regional headquarters (if you know the e-mail address). If you are within the United States, please contact fppf@firstpentecostal.org for U.S. logistics details.

Name…………………………………………………E-mail……….……………………..

Occupation...........……………………………Nationality………………………………….

Home Address………………………………………………………………………………

Mailing Address (if different)………………………………………………………………

Home Phone (       )…………………………Work Phone (       )……………………………

Marital Status (  )    Married (  )   Single (    )   Divorced (  )   Widowed (  )     Separated  (  )

No. of Children  1  2  3  4  5  6  7  8  9    10  More…….. Ages….......…………………...............

Church Represented.............…………………………………………………………………

Name of Pastor (if you are not the pastor)……………………………………………………….

Your Pastor’s Address……………………………………………………………………...

Is you church part of the First Pentecostal Organization?   [Yes]      [No]

Your Bishop's Name:..............................................................................................................

Your Bishop's Address............................................................................................................

Your Goal at the Conference:..................................................................................................

Your Immediate Goal in Ministry…………………………………………………………..

Your Ultimate Goal in Ministry…………………………………………………………….

High School Attended……………………………………………… Graduated…………..

College Attended…………………………………………………… Graduated…………..

Address of College………………………………………………………………………….

Next of Kin:

1……………………………………………………………………………………………

2……………………………………………………………………………………………..

Applicant’s Signature………………………………………Date………………………….

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