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Please tell us a little about yourself as you complete this form. This will give us a bit more understancing of your circumstances and will hopefully allow us to provide a more helpful response. May the Lord grant us both wisdom and discernment through the spirit of truth!


Your Name:
Your Email Address:
Your Biblical or Spiritual Questions, Issues, or Concerns:


Do you currently have a version of MS Word?    yes  no

Other questions that are optional, but the information would be of benefit to us in our effort to minister to your needs:


What is your religious background?   Are you currently attending services?   yes no

GENDER:  Male  Female      AGE GROUP:    <20 21-3031-40 41-50 50>

Country if outside US: 

Any additional information that you think might
better enable us to respond to your inquiry: