60 Haight Street, San Francisco, CA 94102-5895 415.864.2600 www.jewsforjesus.org JEWISH EVANGELISM...

PERSONAL INFORMATION

Name:

Street Address:

City/State/Zip:

Or City

Home phone:

Cell phone:

E-mail:

Birth Date:

Date

T-shirt size:

Citizenship (List the name of the country):

SPIRITUAL LIFE

1. The congregation I attend is:

Name:

Street Address:

City/State/Zip:

Leader's name:

Leader's phone:

Leader's email:

2. Are you a member?

YesNo

3. Have you been baptized?

YesNo

If yes, where and when?

4. Would you have difficulty serving together with Christians of other denominations?

YesNo

5. Are you in agreement with our statement of faith? You can access it HERE.

YesNo

6. How and when did you become a believer in Jesus?*

Select File

EDUCATION EXPERIENCE

7. Highest level of education you've completed (include the name of the school), or what vocational licenses you have:

8. What is your primary language?

9. Do you speak any other languages?

YesNo

If yes, please list the language(s) and your level of proficiency on a range of 1-5 as follows: 1-Beginner; 2-Intermediate; 3-Fluent; 4-Advanced; 5-Native speaker proficiency

Language:

GENERAL INFORMATION

10. Are you currently employed?

YesNo

11. If so, what is your current occupation?

11. If so, what is your current occupation:

12. Are you presently taking any medication?

YesNo

If yes, please list the medications:

12. Where are you planning to take the course?:*

On campusOnline

13. Jews for Jesus' Essentials of Jewish Evangelism on-campus course is held at Moody Bible Institute. Moody is an alcohol- and drug-free campus. Jews for Jesus respects Moody's policy and asks all participants to follow it. Do you agree to follow Moody's no smoking, no alcohol, and no drugs policy throughout your participation in the course?

YesNo

14. How did you hear about this ministry opportunity with Jews for Jesus?

2. Do you smoke?

YesNo

3. Have you abused alcohol or drugs in the last 3 years?

YesNo

If yes, please explain:

EMERGENCY CONTACT INFORMATION

Name:*

Relationship:*

Phone:*

E-mail:

REFERENCES

List the names of your pastor and one elder or mature believing friend whom we can ask to fill out reference forms. Please include all of the following information:

Name:

Phone:

E-mail:

Name:

Phone:

E-mail:

I feel the liberty of the Holy Spirit to fill out this application and if accepted I intend to participate in the course for which I am applying. I hereby affirm all of the statements are true and understand that any knowing misstatement of the facts can bar further consideration for participation with Jews for Jesus.

Signature

Date:

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