Individual Membership

First Name *

Last Name *

Email Address *

Home Address *

Home Address Line 2

Home City *

Home State *

Home Postcode *

Mobile Number *

Christian History

How long have you been a Christian? *

Do you currently attend a Church? *

Yes

Name of current church or last church of regular attendance. *

Contact Details for Pastoral Reference

Are you willing to provide a pastoral reference? *

Yes

Tip: Please note that this is a requirement for membership. If there are extenuating circumstances as to why this cannot be provided, please contact us at info@innerhealing.org.au

Pastor's Name *

Pastor Phone *

Pastor Email *

Details of inner healing or prayer ministry training completed. *

Are you currently involved in Inner Healing or Prayer Ministry? *

Yes

Details of current ministry involvement. *