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Fresno, CA 93701
1(800) 930-6732
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Healing Ministries
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Elijah House School Of Prayer Ministry

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Mr.

Mrs.

Ms.

Miss.

Pastor

Widow

Single Parent

Non U.S. Citizen

Name

First Last

Spouse

First Last

Address

Street Address City State / Province / Region ZIP / Postal Code Country

Church

Home Phone

Work Phone

Fax

Occupation

Age

Which of the following Elijah House books have you read?

Restoring the Christian Family Transforming of the Inner Man

God’s Power to Change

Letting Go of Your Past

Growing Pains

Deliverance and Inner Healing

Elijah Task

Healing the Wounded Spirit

Transformation of the Inner Man

Life Transformed

The Renewal of the Mind

Healing Victims of Sexual Abuse

Why Some Christians Commit Adultery Why Good People Mess Up

Which of the following Elijah House Classes have you completed?

Course 201 (Basic 1) school

Prophetic School

Course 202 (Basic 2) school

Healing of Trauma Seminar

Other Elijah House Seminars/Classes

Which Other?

How long have you been a Christian?

Date of Salvation

MM slash DD slash YYYY

Please give a brief account of when and how you became a Christian.

How are you presently serving the Lord?

Are you in a relationship with a spiritual leader in a pastoral role who knows you, is aware of your spiritual condition, and can hold you accountable?

Yes

Are you presently ministering to others?

Yes

Lay/Church

Lay/Private Professionally

If not, do you plan to do prayer ministry after completing this training?

Yes

Don’t Know

Special Needs or requests (please circle what applies, and briefly explain):

Allergies

Medication

Disability

Dietary

Other

None

Briefly explain:

Because we are dealing with the hearts of people, the school can – at times – be very intense. Personal responses to teaching and small group interaction may include (but is certainly not limited to) some of the following: expression of anger, prejudices and resentments, apprehension, anxiety, insomnia, depression, dissociation, etc. Note: If a crime is confessed in small group during the course of the school, the Facilitator/leader of your small group will need to report it to the Director/Facilitator of the school. The Director/Facilitator of the school, in accordance with the laws of thatstate, may need to report it to the proper authorities. Because of time restraints, all of your personal life issues will not be dealt with during the course of the school. This is a life-long process. However, we do give you the tools to pursue further healing, and you may want to pursue further ministry once the school is complete. If you feel there are already significant life issues that need to be addressed, ministry or counseling prior to your enrollment in the school is advisable and always beneficial. If you have been seeing a counselor, we ask that you discuss the school with your counselor and receive their approval. Their signature is required below.

Having accepted the school enrollment information, requirements outlined in this application, and the ElijahHouse Facilitated School Booklet, I prayerfully submit my application. I agree to respectfully abide by the determination of Elijah House as to the suitability of my attendance at this time. I agree to indemnify and hold Elijah House and any Host Facility harmless for any of my personal responses to the teachings and small group time during the school. I also agree to indemnify and hold Elijah House and any Host Facility harmless for any costs in time, travel, accommodations, or other incidentals, should the school be canceled, my acceptance be delayed, or I am asked to discontinue the course to seek ministry before continuing at another time. I agree to maintain the confidentiality of what is shared by leaders and students in class and small groups. I understand that I may be filmed or photographed during the event for use in future training events and advertisement for display without using my name, and I give permission for use of my image/picture in this way.

Consent(Required)

I understand that my signature testifies that all information provided is true, that I accept all terms of enrollment,and will provide sufficient funds in a timely manner for my participation in the school.

Applicant’s Signature:(Required)

Date(Required)

MM slash DD slash YYYY

Spouse’s Signature:

(Spouse’s Signature is required regardless of whether or not he/she is attending)

Date

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Counselor Name (if applicable):

Counselor Signature:

Address

Street Address City State / Province / Region ZIP / Postal Code

Phone