(PV reserves the privilege to certify youth based on their maturity level)When did you receive Christ as your savior? blanks Have you been baptized in water?blank Have you been baptized in the Holy Spirit? How long have you been attending PV?
Please make sure that all references you supply below meet the following criteria:
1. They can't be a family member
2. They must be 18 years old or older
List the name of someone that you know who attends Pleasant Valley First Name Last Name List the name and complete address of two references who do not attend Pleasant Valley Church. First Name Last Name Street Address Address Line 2 City State Zip First Name Last Name Street Address Address Line 2 City State Zip
The information contained in this application is correct to the best of my knowledge. I authorize any reference or church listed in this application to release information they may have regarding my character and ability to serve at Pleasant Valley Church. I release all such references from liability for any damage that may result from supplying this information.Applicant's Signature: Signature