First Name *
Middle Name
Last Name *
Full Address: (including Postal Code) *
Telephone (Home)
Telephone (Mobile) *
Email *
Occupation/Profession *
Marital Status * MarriedSingleSeparatedEngagedOthers
If Married, Is this your first Marriage? * YesNo
Are you Born Again? * YesNo
If Yes, What Church?
Date of Salvation *
Is your Spouse Born Again? * YesNo
Is He/She a Worker? * YesNo
Give a Short Testimony of your Conversion *
Have you been baptized by Water Immersion? * YesNo
If Yes, When & Where? *
Have you been baptized in Holy Spirit? * YesNo
When did you Join RCCG & Where? *
Have you been a Volunteer/Worker in any Church before? * YesNo
If Yes, What Church? *
What Dept?
Since When?
The Church reserves the right to run a run a background check on you. Do you object? YesNo
Do you hold any Ministerial Title from previous church? YesNo
Ministerial Status Commissioned MinisterOrdained MinisterOthers