Church Planting

First Name:

Middle Name:

Last Name:

Social Security Number:

--

Date of Birth:

Home Phone:

Work Phone:

E-Mail Address:

Wedding Anniverary:

Are you in agreement and support
of your spouse’s
Church Planting decision?

Yes

No

Children under age 18:

Language:

Ethnicity:

Are you currently licensed through Grace International?

Yes

No

If yes, type of license:

Recognitions License

General

Ordained

Date license received:

Grace International District:

Are you a U.S. Citizen?

Yes

No

If not, do you have legal residency?

Yes

No

INS Status

If no, are you able to
legally work in the U.S.?

Yes

No

If you do not have legal residency,
please explain your status with
U.S. Immigration:

CHURCH PLANTER SPOUSE INFO