JGLM Prayer Warrior Application

John G. Lake Ministries
PO Box 140310
Edgewater, CO 80214

Phone: 1-800-707-5003 ext. 4835
Email: contact@ jglm.org
Website: http://www.jglm.org

Please complete this form and read the Prayer Warrior Guidelines.

You will need to be registered on the JGLM Forums to pick up prayer requests. Are you registered? Yes No
If yes, what is your username on the JGLM Forums?
General Information
Are you a monthly pledge partner? Yes No
Did you financially support JGLM this past year? Yes No
Partnership Information
Are you a JGLM Partner? Yes No
Date Applied / MM / DD YYYY
DHT Information
DHT Training Date / MM / DD YYYY
Where did you attend the training? On Location Online
Date DHT form was submitted / MM / DD YYYY
Date of DHT Certification / MM / DD YYYY
Recieved at JGLM convention? Yes No
Leadership Information
Are you a Life Team Leader? Yes No
Date Applied / MM / DD YYYY
Are you a Healing Room Overseer? Yes No
Date Applied / MM / DD YYYY
Are you a State Director? Yes No
Date Applied / MM / DD YYYY
Applicant Information
Name Title First Last Suffix
Address
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Phone - (###) - ### ####
Cell Phone - (###) - ### ####
International phone
Email
Other Email
Web Site
Date Of Birth * / MM / DD YYYY
Age
Gender * Male Female
Marital Status *
Emergency Contact
Name of a friend or relative not residing with you First Last
Relationship
Address
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Phone - (###) - ### ####
Cell Phone - (###) - ### ####
International Phone
Email
Spouse Information
Name Title First Last Suffix
Number
Date Of Birth / MM / DD YYYY
Gender Male Female
Active in Ministry? Yes No
Phone - (###) - ### ####
Cell Phone - (###) - ### ####
International Phone
Email
Prayer Experience
Please list some situations where you have prayed for someone and seen results.
Church Information
Are you participating with a local JGLM Life Team? Yes No
If yes, which one?
Are you licensed or ordained? Yes No
Are you requesting consideration for licensing or ordination by JGLM? * Yes No
Current Church
Your Position
How Long?
Address
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Church Phone - (###) - ### ####
Fax
International Church Phone
Email
Are you or is your church affiliated with any Healing Rooms Organization? Yes No
If so, which one?
Would you be willing to relocate to assist or start new work? * Yes No
How many JGLM meetings have you attended in the past year?
Are you interested in putting a meeting together in your area? Yes No
Personal References
Name First Last
Phone - (###) - ### ####
International Phone
Name First Last
Phone - (###) - ### ####
International Phone
Name First Last
Phone - (###) - ### ####
International Phone
Briefly explain why you wish to volunteer as a Prayer Warrior with JGLM: *
PLEASE READ THE FOLLOWING CAREFULLY BEFORE SIGNING.
I have read the Prayer Warrior Guidelines and agree to adhere to them to the best of my ability. In the event that I cannot I will relinquish my volunteer status immediately. I acknowledge that I agree with the Ministerial Ethnics set forth by JGLM. I hereby state my willingness to submit to the spiritual authority and guidelines of JGLM Prayer Warrior practices. If at any time I feel I can no longer agree with the beliefs and practices of this organization or I cannot function as instructed by JGLM guidelines then I will forfeit my volunteer status. By signing this application I agree with the conditions set forth in the paragraph above and I hereby state that all information contained on the renewal is correct and true.
Electronic Signature of Applicant *
Electronic Signature of Spouse (Only if for a joint membership)
Date * / MM / DD YYYY
I have received/made a copy of this application. * Yes No
Human Verification

JGLM Prayer Warrior Application

JGLM Prayer Warrior Application

General Information

Partnership Information

DHT Information

Leadership Information

Applicant Information

Emergency Contact

Spouse Information

Prayer Experience

Church Information

Personal References

PLEASE READ THE FOLLOWING CAREFULLY BEFORE SIGNING.

Human Verification