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PERSONAL INFORMATION
Surname
First Name
Other Names
Email
Primary Phone Number
WhatsApp Number
RC Number
Gender
Male
Female
Marital Status
Single
Married
Date of Birth
Languages Spoken
State of Origin
Local Govt of Origin
Hometown
Address
City
State
Country
-- Select Country --
NIGERIA
AFGHANISTAN
ALBANIA
ALGERIA
AMERICAN SAMOA
ANDORRA
ANGOLA
ANGUILLA
ANTARCTICA
ANTIGUA AND BARBUDA
ARGENTINA
ARMENIA
ARUBA
AUSTRALIA
AUSTRIA
AZERBAIJAN
BAHAMAS
BAHRAIN
BANGLADESH
BARBADOS
BELARUS
BELGIUM
BELIZE
BENIN
BERMUDA
BHUTAN
BOLIVIA
BOSNIA AND HERZEGOVINA
BOTSWANA
BOUVET ISLAND
BRAZIL
BRITISH INDIAN OCEAN TERRITORY
BRUNEI DARUSSALAM
BULGARIA
BURKINA FASO
BURUNDI
CAMBODIA
CAMEROON
CANADA
CAPE VERDE
CAYMAN ISLANDS
CENTRAL AFRICAN REPUBLIC
CHAD
CHILE
CHINA
CHRISTMAS ISLAND
COCOS (KEELING) ISLANDS
COLOMBIA
COMOROS
CONGO
CONGO, THE DEMOCRATIC REPUBLIC OF THE
COOK ISLANDS
COSTA RICA
COTE D'IVOIRE
CROATIA
CUBA
CYPRUS
CZECH REPUBLIC
DENMARK
DJIBOUTI
DOMINICA
DOMINICAN REPUBLIC
EAST TIMOR
ECUADOR
EGYPT
EL SALVADOR
EQUATORIAL GUINEA
ERITREA
ESTONIA
ETHIOPIA
EXTERNAL TERRITORIES OF AUSTRALIA
FALKLAND ISLANDS (MALVINAS)
FAROE ISLANDS
FIJI
FINLAND
FRANCE
FRENCH GUIANA
FRENCH POLYNESIA
FRENCH SOUTHERN TERRITORIES
GABON
GAMBIA
GEORGIA
GERMANY
GHANA
GIBRALTAR
GREECE
GREENLAND
GRENADA
GUADELOUPE
GUAM
GUATEMALA
GUERNSEY AND ALDERNEY
GUINEA
GUINEA-BISSAU
GUYANA
HAITI
HEARD ISLAND AND MCDONALD ISLANDS
HONDURAS
HONG KONG
HUNGARY
ICELAND
INDIA
INDONESIA
IRAN, ISLAMIC REPUBLIC OF
IRAQ
IRELAND
ISRAEL
ITALY
JAMAICA
JAPAN
JERSEY
JORDAN
KAZAKHSTAN
KENYA
KIRIBATI
KOREA, DEMOCRATIC PEOPLE'S REPUBLIC OF
KOREA, REPUBLIC OF
KUWAIT
KYRGYZSTAN
LAO PEOPLE'S DEMOCRATIC REPUBLIC
LATVIA
LEBANON
LESOTHO
LIBERIA
LIBYAN ARAB JAMAHIRIYA
LIECHTENSTEIN
LITHUANIA
LUXEMBOURG
MACAO
MACEDONIA, THE FORMER YUGOSLAV REPUBLIC OF
MADAGASCAR
MALAWI
MALAYSIA
MALDIVES
MALI
MALTA
ISLE OF MAN (Isle of)
MARSHALL ISLANDS
MARTINIQUE
MAURITANIA
MAURITIUS
MAYOTTE
MEXICO
MICRONESIA, FEDERATED STATES OF
MOLDOVA, REPUBLIC OF
MONACO
MONGOLIA
MONTSERRAT
MOROCCO
MOZAMBIQUE
MYANMAR
NAMIBIA
NAURU
NEPAL
NETHERLANDS ANTILLES
NETHERLANDS
NEW CALEDONIA
NEW ZEALAND
NICARAGUA
NIGER
NIGERIA
NIUE
NORFOLK ISLAND
NORTHERN MARIANA ISLANDS
NORWAY
OMAN
PAKISTAN
PALAU
PALESTINIAN TERRITORY, OCCUPIED
PANAMA
PAPUA NEW GUINEA
PARAGUAY
PERU
PHILIPPINES
PITCAIRN
POLAND
PORTUGAL
PUERTO RICO
QATAR
REUNION
ROMANIA
RUSSIAN FEDERATION
RWANDA
SAINT HELENA
SAINT KITTS AND NEVIS
SAINT LUCIA
SAINT PIERRE AND MIQUELON
SAINT VINCENT AND THE GRENADINES
SAMOA
SAN MARINO
SAO TOME AND PRINCIPE
SAUDI ARABIA
SENEGAL
SERBIA AND MONTENEGRO
SEYCHELLES
SIERRA LEONE
SINGAPORE
SLOVAKIA
SLOVENIA
SMALLER TERRITORIES OF THE UK
SOLOMON ISLANDS
SOMALIA
SOUTH AFRICA
SOUTH GEORGIA AND THE SOUTH SANDWICH ISLANDS
SOUTH SUDAN
SPAIN
SRI LANKA
SUDAN
SURINAME
SVALBARD AND JAN MAYEN
SWAZILAND
SWEDEN
SWITZERLAND
SYRIAN ARAB REPUBLIC
TAIWAN, PROVINCE OF CHINA
TAJIKISTAN
TANZANIA, UNITED REPUBLIC OF
THAILAND
TOGO
TOKELAU
TONGA
TRINIDAD AND TOBAGO
TUNISIA
TURKEY
TURKMENISTAN
TURKS AND CAICOS ISLANDS
TUVALU
UGANDA
UKRAINE
UNITED ARAB EMIRATES
UNITED KINGDOM
UNITED STATES
UNITED STATES MINOR OUTLYING ISLANDS
URUGUAY
UZBEKISTAN
VANUATU
HOLY SEE (VATICAN CITY STATE)
VENEZUELA
VIET NAM
VIRGIN ISLANDS, BRITISH
VIRGIN ISLANDS, U.S.
WALLIS AND FUTUNA
WESTERN SAHARA
YEMEN
YUGOSLAVIA
ZAMBIA
ZIMBABWE
TIMOR-LESTE
Name of Next of Kin
Email of Next of Kin
Phone Number of Next of Kin
Address of Next of Kin
Relationship with Next of Kin
SPIRITUAL INFORMATION
Region
-- Select Region --
REGION 1
REGION 2
REGION 3
REGION 4
REGION 5
REGION 6
REGION 7
REGION 8
REGION 9
REGION 10
REGION 11
REGION 12
REGION 13
REGION 14
REGION 15
REGION 16
REGION 17
REGION 18
REGION 19
REGION 20
REGION 21
REGION 22
REGION 23
REGION 24
REGION 25
REGION 26
REGION 27
REGION 28
REGION 29
REGION 30
REGION 31
REGION 32
REGION 33
REGION 34
REGION 35
REGION 51
REGION 52
REGION 53
REGION 54
REGION 55
REGION 56
REGION 57
REGION 58
REGION 59
REGION 60
REGION 61
REGION 62
REGION 63
REGION 64
REGION 65
REGION 66
REGION 67
REGION 68
REGION 69
REGION 70
REGION 71
REGION 72
REGION 73
REGION 74
SOUTH AFRICA REGION 1
SOUTH AFRICA REGION 2
WEST COAST REGION 1
WEST COAST REGION 2
WEST COAST REGION 3
EAST AFRICA REGION 1
REGION 36
REGION 37
REGION 38
REGION 39
REGION 40
REGION 41
REGION 42
WEST COAST REGION 4
Province
-- Select Region First --
Engagement Status
Full-Time
Part-Time
Staff Type
Select Staff Type
National Staff
Regional Staff
Provincial Staff
Departmental Staff
Missionary Type
Select Missionary Type
Home Missionary
Foreign Missionary
Missionary Role
Select Missionary Role
Pastor
Provincial Missions Coordinator
Regional Missions Coordinator
Country Missions Coordinator
National Missions Coordinator
Place of Primary Assignment
Address
City
State
Country
-- Select Country --
NIGERIA
AFGHANISTAN
ALBANIA
ALGERIA
AMERICAN SAMOA
ANDORRA
ANGOLA
ANGUILLA
ANTARCTICA
ANTIGUA AND BARBUDA
ARGENTINA
ARMENIA
ARUBA
AUSTRALIA
AUSTRIA
AZERBAIJAN
BAHAMAS
BAHRAIN
BANGLADESH
BARBADOS
BELARUS
BELGIUM
BELIZE
BENIN
BERMUDA
BHUTAN
BOLIVIA
BOSNIA AND HERZEGOVINA
BOTSWANA
BOUVET ISLAND
BRAZIL
BRITISH INDIAN OCEAN TERRITORY
BRUNEI DARUSSALAM
BULGARIA
BURKINA FASO
BURUNDI
CAMBODIA
CAMEROON
CANADA
CAPE VERDE
CAYMAN ISLANDS
CENTRAL AFRICAN REPUBLIC
CHAD
CHILE
CHINA
CHRISTMAS ISLAND
COCOS (KEELING) ISLANDS
COLOMBIA
COMOROS
CONGO
CONGO, THE DEMOCRATIC REPUBLIC OF THE
COOK ISLANDS
COSTA RICA
COTE D'IVOIRE
CROATIA
CUBA
CYPRUS
CZECH REPUBLIC
DENMARK
DJIBOUTI
DOMINICA
DOMINICAN REPUBLIC
EAST TIMOR
ECUADOR
EGYPT
EL SALVADOR
EQUATORIAL GUINEA
ERITREA
ESTONIA
ETHIOPIA
EXTERNAL TERRITORIES OF AUSTRALIA
FALKLAND ISLANDS (MALVINAS)
FAROE ISLANDS
FIJI
FINLAND
FRANCE
FRENCH GUIANA
FRENCH POLYNESIA
FRENCH SOUTHERN TERRITORIES
GABON
GAMBIA
GEORGIA
GERMANY
GHANA
GIBRALTAR
GREECE
GREENLAND
GRENADA
GUADELOUPE
GUAM
GUATEMALA
GUERNSEY AND ALDERNEY
GUINEA
GUINEA-BISSAU
GUYANA
HAITI
HEARD ISLAND AND MCDONALD ISLANDS
HONDURAS
HONG KONG
HUNGARY
ICELAND
INDIA
INDONESIA
IRAN, ISLAMIC REPUBLIC OF
IRAQ
IRELAND
ISRAEL
ITALY
JAMAICA
JAPAN
JERSEY
JORDAN
KAZAKHSTAN
KENYA
KIRIBATI
KOREA, DEMOCRATIC PEOPLE'S REPUBLIC OF
KOREA, REPUBLIC OF
KUWAIT
KYRGYZSTAN
LAO PEOPLE'S DEMOCRATIC REPUBLIC
LATVIA
LEBANON
LESOTHO
LIBERIA
LIBYAN ARAB JAMAHIRIYA
LIECHTENSTEIN
LITHUANIA
LUXEMBOURG
MACAO
MACEDONIA, THE FORMER YUGOSLAV REPUBLIC OF
MADAGASCAR
MALAWI
MALAYSIA
MALDIVES
MALI
MALTA
ISLE OF MAN (Isle of)
MARSHALL ISLANDS
MARTINIQUE
MAURITANIA
MAURITIUS
MAYOTTE
MEXICO
MICRONESIA, FEDERATED STATES OF
MOLDOVA, REPUBLIC OF
MONACO
MONGOLIA
MONTSERRAT
MOROCCO
MOZAMBIQUE
MYANMAR
NAMIBIA
NAURU
NEPAL
NETHERLANDS ANTILLES
NETHERLANDS
NEW CALEDONIA
NEW ZEALAND
NICARAGUA
NIGER
NIGERIA
NIUE
NORFOLK ISLAND
NORTHERN MARIANA ISLANDS
NORWAY
OMAN
PAKISTAN
PALAU
PALESTINIAN TERRITORY, OCCUPIED
PANAMA
PAPUA NEW GUINEA
PARAGUAY
PERU
PHILIPPINES
PITCAIRN
POLAND
PORTUGAL
PUERTO RICO
QATAR
REUNION
ROMANIA
RUSSIAN FEDERATION
RWANDA
SAINT HELENA
SAINT KITTS AND NEVIS
SAINT LUCIA
SAINT PIERRE AND MIQUELON
SAINT VINCENT AND THE GRENADINES
SAMOA
SAN MARINO
SAO TOME AND PRINCIPE
SAUDI ARABIA
SENEGAL
SERBIA AND MONTENEGRO
SEYCHELLES
SIERRA LEONE
SINGAPORE
SLOVAKIA
SLOVENIA
SMALLER TERRITORIES OF THE UK
SOLOMON ISLANDS
SOMALIA
SOUTH AFRICA
SOUTH GEORGIA AND THE SOUTH SANDWICH ISLANDS
SOUTH SUDAN
SPAIN
SRI LANKA
SUDAN
SURINAME
SVALBARD AND JAN MAYEN
SWAZILAND
SWEDEN
SWITZERLAND
SYRIAN ARAB REPUBLIC
TAIWAN, PROVINCE OF CHINA
TAJIKISTAN
TANZANIA, UNITED REPUBLIC OF
THAILAND
TOGO
TOKELAU
TONGA
TRINIDAD AND TOBAGO
TUNISIA
TURKEY
TURKMENISTAN
TURKS AND CAICOS ISLANDS
TUVALU
UGANDA
UKRAINE
UNITED ARAB EMIRATES
UNITED KINGDOM
UNITED STATES
UNITED STATES MINOR OUTLYING ISLANDS
URUGUAY
UZBEKISTAN
VANUATU
HOLY SEE (VATICAN CITY STATE)
VENEZUELA
VIET NAM
VIRGIN ISLANDS, BRITISH
VIRGIN ISLANDS, U.S.
WALLIS AND FUTUNA
WESTERN SAHARA
YEMEN
YUGOSLAVIA
ZAMBIA
ZIMBABWE
TIMOR-LESTE
Present Misssion Field
Date Assigneed to Mission Field
Date Born Again
Where Born Again
Date Joined RCCG
Where you Joined RCCG
Date of Water Baptism
Where you had Water Baptism
Date Baptized of the HolyGhost
Where were Baptized of the HolyGhost
Date SOD was completed
Date Workers in Training was completed
Date Bible College was completed
Date School of Mission was completed
School of Mission Attended
School of Mission's Address
Last Ordination
-- Select Ordination Status --
Brother
Sister
Deacon
Deaconess
Assistant Pastor
Pastor
Year of last Ordination
CHILDREN INFORMATION
1st Child's Information
Surname
First Name
Other Names
Gender
-- Select Child's Gender --
Male
Female
Date of Birth
Present Class
-- Select Present Class --
NURSERY CLASS 1
NURSERY CLASS 2
NURSERY CLASS 3
PRIMARY CLASS 1
PRIMARY CLASS 2
PRIMARY CLASS 3
PRIMARY CLASS 4
PRIMARY CLASS 5
PRIMARY CLASS 6
JUNIOR SECONDARY SCHOOL 1
JUNIOR SECONDARY SCHOOL 2
JUNIOR SECONDARY SCHOOL 3
SENIOR SECONDARY SCHOOL 1
SENIOR SECONDARY SCHOOL 2
SENIOR SECONDARY SCHOOL 3
None of the Above
2nd Child's Information
Surname
First Name
Other Names
Gender
-- Select Child's Gender --
Male
Female
Date of Birth
Present Class
-- Select Present Class --
NURSERY CLASS 1
NURSERY CLASS 2
NURSERY CLASS 3
PRIMARY CLASS 1
PRIMARY CLASS 2
PRIMARY CLASS 3
PRIMARY CLASS 4
PRIMARY CLASS 5
PRIMARY CLASS 6
JUNIOR SECONDARY SCHOOL 1
JUNIOR SECONDARY SCHOOL 2
JUNIOR SECONDARY SCHOOL 3
SENIOR SECONDARY SCHOOL 1
SENIOR SECONDARY SCHOOL 2
SENIOR SECONDARY SCHOOL 3
None of the Above
3rd Child's Information
Surname
First Name
Other Names
Gender
-- Select Child's Gender --
Male
Female
Date of Birth
Present Class
-- Select Present Class --
NURSERY CLASS 1
NURSERY CLASS 2
NURSERY CLASS 3
PRIMARY CLASS 1
PRIMARY CLASS 2
PRIMARY CLASS 3
PRIMARY CLASS 4
PRIMARY CLASS 5
PRIMARY CLASS 6
JUNIOR SECONDARY SCHOOL 1
JUNIOR SECONDARY SCHOOL 2
JUNIOR SECONDARY SCHOOL 3
SENIOR SECONDARY SCHOOL 1
SENIOR SECONDARY SCHOOL 2
SENIOR SECONDARY SCHOOL 3
None of the Above
UPLOAD DOCUMENTS
Upload Passport Photograph
Upload Marriage Certificate
Upload SOD Certificate
Workers-in-Training Certificate
Baptismal Certificate
Bible College Certificate
School of Mission Certificate
Family Picture (1)
Family Picture (2)
Family Picture (3)
Family Picture (4)
Family Picture (5)
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