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Mentoring Program Application Form

1) Full Name *

First

Last

2) Mobile No. (please include Country Code for foreign number) *

3) Email *

4) Gender *

5) Age *

6) Education/Qualification *

7) Profession/Occupation/Title *

8) Are you a Business Owner or Entrepreneur? *

9) Name of Company that you own or work for *

10) Church *

11) Are you involved in any Church/Ministry Activities? If yes, please specify. *

12) Are you involved in any Christian Marketplace Activities? If yes, please specify. *

13) Have you been involved with GBN? Have you attended any GBN activities or events? If yes, please specify. *

15) Please elaborate on the area(s) specified in Question 14. *

16) Please identify your desired mentoring goals/outcomes. *

17) Country you are based in, if not in Singapore.

I have read and agree to the Personal Data Declaration below. *

Yes, I agree

PERSONAL DATA DECLARATION - "I agree that GBN may collect, use and disclose my personal data for management and administrative purposes, including evaluation of my application as well as other purposes as permitted by the Personal Data Protection Act." (Please contact us at connect.gbn@gmail.com should you require clarification on the collection, use or disclosure of your personal data.) "I also agree to grant GBN permission to include me in GBN's mailing list." (You can revoke permission at any time using the SafeUnsubscribe® link found at the bottom of every email. We DO NOT spam and we take your privacy seriously.)

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