Name. _____________________________________________.
Address 1. _________________________________________.
Address 2. _________________________________________.
City. ___________. State. ________. Zip Code. __________.
Country. _____________________. Age. ______________.
Religious Denomination (Baptist, etc.). ___________________.
1.) What year did you become a Christian? _______________.
2.) How old were you then? __________________.
3.) When and where were you baptized into the Christian
faith? _____________________________________________
___________________________________________________
___________________________________________________
___________________________________________________.
4.) Please describe your born-again experience. __________
___________________________________________________
___________________________________________________
___________________________________________________
___________________________________________________
___________________________________________________
___________________________________________________
___________________________________________________
___________________________________________________.
5.) Do you believe that Jesus Christ died for your sins and the sins of the world and was bodily resurrected from
the grave 3 days later? Yes. ____. No. ____. Your Initials. _____.
6.) Do you believe in the existence of the Trinity (one God in three Persons)? Yes. ____.
No. _____. Your Initials. ____.
7.) Do you understand and believe that acceptance of Jesus Christ as Lord and Savior is a personal experience that comes
from the heart of a person? Yes. ____. No. ____.
8.) Do you believe that Jesus Christ is eternal God who came to us in human form (the Incarnation)? Yes.
____. No. ____.
9.) If certified as an Exorcism-Deliverance Minister by Jordan Christian Ministries and the American Association
of Exorcists, do you plan to conduct your ministry in a manner that brings glory to Jesus Christ? Yes. ____.
No. ____.
10.) Do you understand and accept that Jordan Christian Ministries and the American Association of Exorcists reserves
the right to revoke your certification as an Exorcism-Deliverance Minister should you conduct your personal life or ministry
in any way that brings disrespect upon the name of Jesus Christ (example would be sexual immorality)?*
Yes. ____. No. ____.
11.) Do you understand and agree that should your certification as an Exorcism-Deliverance Minister be revoked,
you can appeal the decision by the Board once but must abide by the final decision? Yes. ____. No.
____.
12.) Do you understand and agree that there must be presented clear and definitive evidence as to why the revocation
order should be reversed? Yes. ____. No. ____.
13.) Do you understand and agree that certification as an Exorcism-Deliverance Minister is only for the sole purpose
of a ministry in Exorcism-Deliverance (i.e., you are not an Ordained Minister and cannot conduct weddings, funerals,
baptisms, or any other function of an Ordained Minister)?
Yes. ____. No. ____. (Jordan Christian Ministries does provide ministerial ordination for Christians
interested in going into the ministry but it is under separate application. Go to
www.jordanchristianministries.org if interested).
14.) Do you agree to hold Jordan Christian Ministries and the American Association of Exorcists harmless and waive
the right to legal action for any failures or problems that might occur in your exorcism-deliverance ministry?
Yes. ____. No. ____.
_______________________ __________________________
Signature of Applicant Applicant's
Printed Name
_________________
Date Signed
*Jordan Christian Ministries and the American Association of Exorcists does not easily revoke certification of an exorcism-deliverance
minister but does so as a last resort to solution of problems. However, we will not associate our ministries with anyone
involved in illegal or immoral conduct or in any activity which brings disrespect upon these ministries or upon the name of
Jesus Christ. We are biblically-based ministries which take our missions seriously. No one involved in the occult
or the cults will be granted membership or cetrtification or affiliation with any of our ministries.
Note: When sending checks for payment of courses, please make the checks out to:
Jordan Christian Ministries
Checks must be for U.S. currrency and drawn on U.S. banks. Money orders in U.S. currency are accepted.
For those in Third World countries with poverty, contact the AAE or Jordan Christian Ministries at PreacherNurse@aol.com.