New Creation Covenant Churches International
New Creation Covenant Churches International
New Creation Covenant Churches International

EHSM Enrollment Form

 

 

 

 

 

Date:

Name:   Date of Birth:

Street Address:  

City:   State:   Zip:   Country:

Home Phone:   Cell:

Primary E-mail Address:

Are you a Licensed and/or Ordained Minister? (Select one) 

If yes, please list your date of Licensing and/or Ordination:

Are you enrolled in your church's Minister-In-Training Program? (Select one)   

Are you a Member of NCCCI? (Select one)  

Are you a Member of New Creation? (Select one) 

If NO, please list the name of your Church and Senior Pastor:

Church Name: 

Senior Pastor's Name:

Highest Grade Level Completed:

Program of Study: (Select one)

I will be attending classes: (Select one)

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