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SOZO APPLICATION FORM
Phone
SOZO Application
Date:
*
Name:
*
Email Address:
*
Mailing Address:
*
Phone Number:
*
Gender:
*
Male
Female
Age:
*
Church Attending:
*
Have you received ministry from North Palm’s SOZO Team in the past?
*
Yes
No
Approximate Date:
*
Have you ever attended a North Palm:
*
Encounter
School of Discipleship
Discovery Session
Please check all that apply.
Who referred you to SOZO?
*
Why would you like to receive a SOZO?
*
Please check any of the following that previously and currently apply to you.
*
Anxiety
Physically Abusive
Depression
Violent
Sexual Promiscuity
Criminal Record
Recent Loss
