Name (*)
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Email (*)
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Address (*)
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City (*)
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State (*)
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Zip Code (*)
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Phone (*)
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Alternate Phone
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Gender (*)
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Marital Status
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Church Attending
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Church City & State
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Have you received SOZO Ministry before? (*)
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If yes, please approximate date of ministry (mm/yy)
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Why would you like to receive a SOZO? (*)
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Are you presently, or have you in the past, been ministered to by any other ministry of Life Church? (*)
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If yes, with whom or what ministry?
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Approximate date of past ministry (mm/yy):
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Have you received counseling through your church or a licensed counselor? (*)
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If yes, with whom?
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Who referred you to the SOZO Ministry?
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Do you attend a cell group or a home group? (*)
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Do you have a leadership role in your church? (*)
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If yes, please describe:
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Will you be able to fast or pray prior to your SOZO? (*)
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If yes, ask the Lord what He wants you to fast. It could be a fast of one meal per day, certain foods, or watching TV, for example.
SOZO Ministry sessions are currently scheduled for Thursday evenings at 6:30pm and may run from 1 to 3 hours. Does this time frame work for you? If not, please specify the dates and times that would work best for you. (*)
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There is a suggested donation of $25.00 per session to help with the expenses of this ministry, for continued training of the SOZO Ministry Team and for the value of the time spent with you. Will you be able to donate to the SOZO Ministry? (*)
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Your donation can be sent to (checks payable to Life Church):
Life Church
P.O. Box 5350
Salem, OR 97304
Please carefully read the following and, if you agree, type your name at the bottom. By doing so, you are agreeing to the fact that your typed name is acting as your personal electronic signature:
I acknowledge that team members from Real Life Ministries of Life Church have voluntarily agreed to pray for me. I understand that this session is not a professional counseling meeting and that none of the team members are licensed counselors. I understand that these team members are, to the best of their ability, doing what they can to help me achieve more freedom in my life.
I understand that Life Church is a nonprofit organization that makes no charge for its services. I further state that I have voluntarily sought assistance of my own initiative and that I am under no obligation to accept or reject any of the advice or help that I might receive from the team members of this ministry.
Our team members offer biblical spiritual services to anyone who desires them regardless of ability to pay. Although there is no charge for our services, all efforts to build this ministry support and train our team members are paid directly form the donations of those receiving services. We therefore have a suggested donation of $25.00 or more per visit. Your contributions to this ministry are greatly appreciated because they support our further development. Please make donations payable to "Life Church." Any donations above the suggested donation of $25.00 are tax deductible. If you would like a tax deductible receipt, we will provide one for you upon request. Thank you!
I understand that if I receive ministry from Real Life Ministries, the team is committed to respect the disclosed information, but NOT to complete confidentiality. The information, as needed, may be shared with other leaders of Real Life Ministries so as to further your total healing process. This may include future meetings with spiritual mentors in the church to set appropriate boundaries for your personal and spiritual growth.
I agree to hold Life Church and its team members free from any and all liability, loss, or damage of any kind that may arise as a result of assistance which I have received or from my involvement with Life Church.
I have read this disclaimer and release of liability. I understand, agree, and have executed it as my free and voluntary act. I also certify that I am 18 years or older, that I have read this document carefully, and that I understand its contents; or that I am under 18 and both my guardian and I are signing to certify these things.
Signature of Participant (*)
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Signature of Parent/Guardian (if participant under 18)
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Once your paperwork is received, we will contact you to schedule an appointment. Thank you!
