I. Personal Details Title * - Select -MrMsMrsMissDrPsRev Surname * Given Name * Name as in NRIC * Last 3 Digits + Alphabet of NRIC * Home Address * Postal Code * Telephone No. Home Office Mobile * Email Address * Gender * Male Female Height Date of Birth * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year19231924192519261927192819291930193119321933193419351936193719381939194019411942194319441945194619471948194919501951195219531954195519561957195819591960196119621963196419651966196719681969197019711972197319741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999200020012002200320042005 Age * Race * Nationality * Occupation * Marital Status * - Select -SingleEngagedMarriedRemarriedDivorcedWidowed Name of Team Pastors * - Select -Asher & Wendy EngCheng Kim Meng & Huey TengDaniel & Patsy GanEugene & Dorothy TanLoke Mun Tai & AliciaPatrick & Hilary PangPoh Wee Long & CristabelRichard & Jenny OngRoland Lee & Lai FunMarilyn YeeTay Chin Kwang & Hsiu ChinWang Guanghan & Melissa Name of G12 Leader * Name of Cell Leader * II. Education/Skills/FCBC Equipping Status Highest Education Level * GCE ‘O’ Level GCE ‘A’ Level Polytechnic University Post-graduate Others If Others, please specify Language(s)Specify which languages or dialects you are able to communicate in: English * - Select -FluentModerateA Little Chinese - None -FluentModerateA Little Japanese - None -FluentModerateA Little Tetum - None -FluentModerateA Little Hokkien - None -FluentModerateA Little Cantonese - None -FluentModerateA Little Others (Please specify) Specialised Skills (Please specify) FCBC Equipping Status (Highest level completed) * III. Conversion/Church Affiliation/Christian Service No. of years as a Christian * No. of years as a FCBC member * Are you currently leading an open cell/G12 group? * Yes No Please state other current ministry involvements (FCBC or others), if any IV. Information On Other Matters Have you suffered or are you suffering from any serious illnesses? * Yes No Do you have any physical disabilities or allergies? * Yes No Have you ever suffered from depression, insomnia, or anorexia? * Yes No Have you ever used illegal drugs? * Yes No Have you been dismissed or suspended from the service of any employer? * Yes No Are you a bankrupt or a discharged bankrupt? * Yes No Are you in debt? * Yes No If you answered “Yes” to any of the above questions, please elaborate in terms of the nature/extent/date/duration/reason Terms * By submitting this form, I permit FCBC to contact me in response to my application. Applicants will be required to attend an interview with the Selection Committee.