KMTA Referral Form (church leaders only)KMTA Level 1 Certificate in Ministry Training REFERRAL FORM (FROM LEADERS) This form is used by church/ministry leaders with earmarked church members who need ministry training in the occupational areas KMTA provides. Please read carefully. If you have any queries in completing this form, please email us at [email protected], and a KMTA staff member will contact you in a few days. IMPORTANT Learners are not enrolled on KMTA until deposits are paid and standing order confirmation is received. First NameLast NamePhoneEmailChurch Information:Church AddressChurch NameCityPostcodeCountryAfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelauBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongo (Brazzaville)Congo (Kinshasa)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyIvory CoastJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao S.A.R., ChinaMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussiaRwandaSão Tomé and PríncipeSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint Martin (Dutch part)Saint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia/Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited Kingdom (UK)United States (US)United States (US) Minor Outlying IslandsUnited States (US) Virgin IslandsUruguayUzbekistanVanuatuVaticanVenezuelaVietnamWallis and FutunaWestern SaharaYemenZambiaZimbabweMEMBERSHIPS 1. PROPHETIC 2. INTERCESSION 3. MENTOR You can refer up to 5 people on this form. If you want to refer more people, please state the names etc on the ‘additional information’ section. REFERRAL 1. Can you provide the name, email and mobile of the person you wish to refer to KMTA SELECT 1 MEMBERSHIP YOU WANT THEM TO BE TRAINED UNDER– Select –PROPHETICINTERCESSIONMENTORINGHave you spoken to them about this training? Yes NoREFERRAL 2. Can you provide the name, email and mobile of the person you wish to refer to KMTA SELECT 1 MEMBERSHIP YOU WANT THEM TO BE TRAINED UNDER– Select –PROPHETICINTERCESSIONMENTORINGHave you spoken to them about this training? Yes NoREFERRAL 3. Can you provide the name, email and mobile of the person you wish to refer to KMTA SELECT 1 MEMBERSHIP YOU WANT THEM TO BE TRAINED UNDER– Select –PROPHETICINTERCESSIONMENTORINGHave you spoken to them about this training? Yes NoREFERRAL 4. Can you provide the name, email and mobile of the person you wish to refer to KMTA SELECT 1 MEMBERSHIP YOU WANT THEM TO BE TRAINED UNDER– Select –PROPHETICINTERCESSIONMENTORINGHave you spoken to them about this training? Yes NoREFERRAL 5. Can you provide the name, email and mobile of the person you wish to refer to KMTA SELECT 1 MEMBERSHIP YOU WANT THEM TO BE TRAINED UNDER– Select –PROPHETICINTERCESSIONMENTORINGHave you spoken to them about this training? Yes NoTell us how our training will help them progress the vision God has given you ?Additional Information The duration of the tuition is 12 months. Payment is as follows: For 1 Student £100 deposit + £25 per month x 12 months tuition = £400.00 per student Payment is made via Standing order instalments or payment in full. STANDING ORDER DETAILS: Business name: BWS Enterprise CIC Sort Code: 40-19-15 Account no: 94674979 YOUR REF: Please put your Church initials & postcode/KMTA eg: NTCGB702kB/KMTAKMTA TUITION FEES We will be paying deposit & Standing Order We will be paying in fullAFTER you press submit SAVE the form by pressing ‘SAVE & RESUME’ button. keep the link to open your form. Pay the deposit for each learner and set up the standing order. Submit your form to us! Save & ResumeSubmit Form
