SUPPLEMENTARY MINISTRY TRAINING PROGRAMME (SMTP)

Personal Information Sheet

This Application Form consists of three sections, each of which should be completed by the Applicant. Questions marked with an asterick must be answered.

* required field.

 

	Section I: Applicant Information
1.	Prefix:	Mr. Mrs. Miss. Ms.
2.	First Name:	*
3.	Middle Name:	*
4.	Last Name:	*
5.	Preferred Name:
6.	Are you a new applicant or are you re-entering. If re-rentering, state the reasons why you left and are at this time re-entering the programme.
7.	What year do you propose to commence training
8.	To what Cure/Region do you belong
9.	What is the name of the Church/Mission where you are a member
10.	What is the name of your Rector/Priest
	Section II Personal Information
1.	Date of birth	year20242023202220212020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924/month123456789101112/day12345678910111213141516171819202122232425262728293031 yyyy/mm/dd *
2.	Place of birth (district, town, parish, country)	*
3.	Nationality	*
4.	Gender	Male Female *
5.	Marital Status	Single Married Widowed *
6.	Current Address	*
7.	Home telephone number	*
8.	Mobile telephone number	*
9.	E-mail address	*
10.	Current occupation	*
11.	How long have you been engaged in this occupation	*
	Section III - Family Information
1.	Spouse's first name	*
2.	Spouse's last name (if different from yours)	*
3.	Spouse's occupation	*
4.	List the names and ages of your children	*
5.	Emergency Contact Name	*
6.	Emergency Contact Telephone number	*
7.	Next of Kin Name	*
8.	Next of Kin Telephone Number	*
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