Iowa NextGen Database

1

Your Name* This field is required.

First Name

Last Name

2

Your Email* This field is required.

example@example.com

3

Your Phone Number* This field is required.

Please enter a valid phone number.

4

Are you married?If so, what is your spouse's name and when is your anniversary?

5

Do you have children?If so, what are their name(s) and birthdate(s)?

6

Church Name* This field is required.

7

Church City* This field is required.

8

Which Ministry Do You Serve In?* This field is required.Select all that apply

KidMin

Youth

Young Adults

All of the above

9

Are you...* This field is required.Select one

Full-Time

Part-Time

Bi-Vocational

Volunteer

Lead Pastor filling this role

Lead Pastor's Spouse filling this role

10

Credentials?* This field is required.Select one

Certified AG Minister

Licensed AG Minister

Ordained AG Minister

Working On Credentials

Not Credentialed

My Church Is A NON-AG Church

11

Tell us about you!What are some of your favorite drinks, snacks, candy, restaurants, places to shop, hobbies, etc.

12

If you were given $100k, what would you do with it?This is just for fun. IMN and Iowa NextGen is not giving cash away.

13

Is there anything else you would like us to know about you?