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Name of Composer

Address:

City: State: Postal Code:

Country:

E-mail address:

Phone Number: FAX Number:

Please tell us what you believe about God:

Please tell us what you believe about Jesus Christ:

Please tell us what you believe about the Holy Spirit:

Please tell us briefly about the testimony of your walk with the Lord:

If we asked your Pastor or Church leaders about you, what would they say?

Pastoral referral -

Name of Pastor:

Pastor's phone number:

Pastor's e-mail:

Pastor's mailing address: