Registration Form For

           Team Members

 

FIRST NAME		LAST NAME
SPOUSE'S NAME
E-MAIL ADDRESS
ADDRESS
CITY / STATE / ZIP
HOME PHONE
WORK PHONE
CELL PHONE
Check your preferred responsibility as a Team Member (You can check more than one)
Adult Team Leader Coordinator Assistant Youth Team Coordinator Youth Assistant Children Team Coordinator Children Assistant LRW Coordinator Music Leader LMW Coordinator LMW Teacher Discipleship Coordinator Discipleship Weekend Teacher MEW Coordinator MEW Teacher Exp God Coordinator Exp God Weekend Teacher
Would you consider helping in any of the following areas (You can check more than one)
	CRJ Consultant (Help promote the Church Renewal Journey to pastors, Associational Meetings & etc) Special training and promotional materials are available. This is a great way Pastors can support the Church Renewal Journey.
	CRJ Prayer Supporter (Lifting CRJ Coordinators, Team Members and their Weekends in prayer) (Contacting them by notes or emails prior to their weekends and encouraging them by letting them know you are praying for them and their weekend.)
	CRJ Pastor (a pastor, who has experienced Renewal at your church and would speak to other pastors) (We would like to list you as a pastor that would be willing to discuss CRJ with other pastors who are considering the Journey for their church.)
DATE OF BIRTH	January February March April May June July August September October November December 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31   1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919 1918 1917 1916 1915 1914 1913 1912 1911 1910 1909 1908 1907 1906 1905 1904 1903 1902 1901 1900
EMERGENCY CONTACT INFORMATION:
CONTACT NAME		RELATION TO YOU
PHONE NUMBER
CHURCH INFORMATION:
CHURCH		CITY
NAME OF YOUR STATE CONVENTION
Do you now or have you previously served in any office or position such as State Renewal Coordinator, Renewal Consultant, or Renewal Coordinator for your state or association? If so, please list with approximate dates:
Have you ever served as a Team Member		- Yes No
If YES, Approx Date of your last weekend		Coordinator's Name
List any special talents such as soloist, pianist, instrumentalist, luncheon speaker, etc.