April Church Planter Assessment

Location: Spanish Fork, UT
Dates: April 15-17, 2020

Candidate Name*
First Last
Candidate Date of Birth*
MM slash DD slash YYYY
Spouse Name*
First Last
Spouse Date of Birth*
MM slash DD slash YYYY
Anniversary*
MM slash DD slash YYYY
Names and Ages of Children*
Candidate Email*
Spouse Email*
Best Contact Number*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Sponsoring Organization (if not Plant Utah)
Organization Contact Person
Contact Person Phone
Contact Person Email
Who is Paying the Assessment Fee?*
Project Name
If you are currently being considered for a specific project, please provide the location of the project and your role
List any dietary/food restrictions and/or allergies

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Name*

Email*

Phone*

Church or Organization Website

I'm interested in:*

Church Planting Networks

Supporting Church Planting

Plant Utah Prayer Team

Church Planting Teams

Planting a Church in Utah

Church Planter Residency

Ministry Internship

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