Due to the nature of this program and the limited number of spaces available, all registration forms will go through a process of selection and placement. Please help us get to know you by filling up this form and indicate a reference who will help us discern together with you, your readiness and timing of joining this program. We ask that you pray with us in this discernment process as the Institute for Christian Ministry (ICM) makes the final consultative decision.

Please submit your application by May 30^th, 2010

The Journey 2010 Registration Form *Name: *Designation: *Age Group: - Select Group - Youth (up to 21) Young Adult (21-30) Adult (31-49) Senior Adult (50-65) Super Seniors (above 65) *Gender: Male Female *Maritial Status: Single Married Others Occupation: - Select Occupation - Student Full time employment Part time employment Own business Freelance Professional Home maker Retired Others *Tel: (Home) (Office) (H/P) Address: *Email: Local Church Name: Christian Since: (Year) Role in Church: Eg: LCEC (pls state capacity), PCT, PPRC, Bible Study Leader, Small Group/Cell Group Leader, Organization Leader (MSF, MW, MYF, MYAF, BB/GB, etc), or Others. Role Duration: How long have you been in this role? Comments/ Remarks: What draws you to apply for THE JOURNEY at this time in your life? Please give us a reference - a pastor/church leader who supports you for this program, name and email) How does this person know about your spiritual life? Please respond to the following questions: 1.What ministries or programs have helped you grow as a Christian? 2.Besides your conversion experience, what experience has had a deep impact on your spiritual life? Why? 3.What life experience has been significant in fostering your spiritual growth up to now? What life experience has hindered you most? 4.Name a specific person who has greatly contributed to your spiritual growth and describe how this person has helped you in your spiritual development. *Verification Code: Please enter the text above into the box:

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