| City and State of local ministy group: |
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| If this is a student group, name of school: |
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| Select type of group: |
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Beginning with your name, please list 3 CMDA members who are
leaders for the present year beginning with your own name and
E-mail address:
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| Name: |
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| E-Mail: |
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| Cell Phone: |
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| If student, present year in program
(example: 1st year, 2nd year,etc): |
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| If student, expected graduation date: |
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| Name: |
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| E-Mail: |
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| Cell Phone: |
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| If student, present year in program
(example: 1st year, 2nd year,etc): |
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| If student, expected graduation date: |
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| Name: |
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| E-Mail: |
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| Cell Phone: |
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| If student, present year in program
(example: 1st year, 2nd year,etc): |
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| If student, expected graduation date: |
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Briefly describe weaknesses and strengths in your local
ministry group in the past year:
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Briefly describe your general activities over the past year:
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List resources that you think will help you do what God has called
your ministry to do:
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