Blessing Interview Form (Page 4 of 4) in pdf

Blessing I nterview F orm

Blessing & F amily M inistry, F FWPU-‐USA

“This i s m y f ull c onfession a nd e xplanation t o t he b est o f m y k nowledge:”

Applicant’s S ignature _ _________________________________________ D ate__________________________

Applicant N ame ( last, f irst) _ _____________________________________

Applicant’s P arents’ S ignature ( Optional)

Signature___________________________________________________ D ate: _ _______________________

Print N ame _ _________________________________________ E -‐mail: _ ______________________________

Confirmation o f t he I nterview a nd C onfession

I h ereby c onfirm t hat:

This a pplicant h as r emained s exually p ure, o r h as r emained s exually a bstinent f or a t l east o ne y ear.

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This a pplicant a ppears t o u nderstand t he m eaning a nd v alue o f t he B lessing.

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This a pplicant a ppears t o b e r eady t o m ake a n e ternal c ommitment t o a s pouse.

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Comments a nd R ecommendations: _ ___________________________________________________________

_____________________________________________________________________________

____________________________________________________________________________

“I a ttest t o h aving i nterviewed t his a pplicant a nd r eceived h is/her c onfession.”

Interviewer’s S ignature: _ _______________________________________ D ate: _ ______________

Print N ame _ ________________________________________ P osition _ ______________________________

Phone a nd E mail: _ __________________________________________________________________________

The I nterview a nd C onfession m eets t he a pproval o f:

Applicant’s L ocal P astor’s S ignature _ ________________________________ D ate:______________________

Print N ame _ _________________________________________ E -‐mail: _ ______________________________

Ver: J anuary 1 8, 2 014; K eep o riginal w ith i nterviewer o r l ocal B FM. U pload s ignature p age o nly w ith o nline a pplication.

Destroy o riginal a fter a pplicant i s B lessed.

Blessing Interview Form Page 4