LC: PERSONAL DATA FOR NEW DISCIPLES FORM
(This form is to be completed in full by all new disciples, 16 years old and above. Please enclose with your TRF)

Date:

Bible name:

Legal name:

Age:     Date of birth: ___/___/___       Sex: M___ F___

Nationality:

Passport and/or ID number:

Names and ages of children joining:

Home number of Home joined:

IN CASE OF EMERGENCY, PLEASE CONTACT PARENTS AND/OR NEXT OF KIN

Name: ___________________________________________________

Address: _________________________________________________

Phone number: ________________________

Occupation: ______________________________________________

Relationship to you: _______________________________________

Attitude of parents (or next of kin) towards the Family (Please briefly describe.): _______________________________________________

BACKGROUND INFORMATION:

Previous education: __________________________________________

Jobs held: __________________________________
Languages spoken: ___________________________________________
Marital status: _______________________________

Medical history (Please briefly describe any current afflictions, history of mental illness, handicaps, or long-standing illnesses.): ____________________________________________________________________________________________________________________

Former religion: ____________________________

TALENTS:
Please list what you consider to be your talents and abilities, or professional qualifications.

Signature ___________________________________

(The following to be filled in by a Home teamwork member before this form is sent to the continental office)

I affirm that this new member has taken his AIDS test and tested negative.

Signature ___________________________________


Copyright (c) 1998 by The Family