<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd"> <html xmlns="http://www.w3.org/1999/xhtml"> <head> <meta http-equiv="Content-Type" content="text/html; charset=utf-8" /> <title> Present Testimony Ministry</title> <style type="text/css" media="all"> @import "layout.css"; </style> </head> <body class=""> <div id="wrapper"> <div id="section_header_wrapper"> <div id="section_header"></div> </div> <div id="content_wrapper"> <div id="content"> <div id="main"> <h1 align="center">Pastors and Church Leaders</h1> <p align="center"><font face="Arial" size="2">Many times Frank Viola will be in a particular city for a conference or event, and pastors/church leaders will find out later and write to us saying, &quot;I wish I would have known that Frank was in town.&quot;</font></p> <p align="center"><font face="Arial" size="2"> By filling out this form, you will be alerted when Frank is in your city or nearby. We will also use it to invite you to future <i>Leadership Conferences</i>. Please fill out all boxes. Your information will remain private with us.</font></p> <div> <p><form action="http://www.ptmin.org/form_tools/process.php" method="post"> <input type="hidden" name="form_tools_form_id" value="7" /> <table border="1" cellspacing="0" width="96%" cellpadding="2" bgcolor="#EFF2F7"> <tr> <td width="50%" bgcolor="#FFFFFF" align="right"><font face="Verdana" size="2"><font color="#800000"><b>*</b></font>&nbsp;First Name:&nbsp;</font></td> <td width="50%" bgcolor="#ECEFF6"><input type="text" name="FirstName" size="20"></td> </tr> <tr> <td width="50%" align="right"><font face="Verdana" size="2"><font color="#800000"><b>*</b></font>&nbsp;Last Name</font></td> <td width="50%" bgcolor="#F6F7FB"><input type="text" name="LastName" size="20"></td> </tr> <tr> <td width="50%" align="right"><font face="Verdana" size="2"><font color="#800000"><b>*</b></font>&nbsp;City:</font></td><td width="50%" bgcolor="#F8F9FD"><input type="text" name="City" size="20" maxlength="45"> </tr> <tr> <td width="50%" align="right"><font face="Verdana" size="2"><font color="#800000"><b>*</b></font>&nbsp;State/Province:</font></td><td width="50%" bgcolor="#F8F9FD"><input type="text" name="State" size="25"> </tr> <tr> <td width="50%" align="right"><font face="Verdana" size="2"><font color="#800000"><b>*</b></font>&nbsp;Country:</font></td><td width="50%" bgcolor="#F8F9FD"><input type="text" name="Country" size="20"> </tr> <tr> <td width="50%" align="right"><font face="Verdana" size="2"><b><font color="#800000">*</font></b>Email Address</font></td> <td width="50%" bgcolor="#F1F4F9"><input type="text" name="email" size="35"></td> </tr> <tr> <td width="50%" align="right"><font face="Verdana" size="2"><font color="#800000"><b>*</b></font>&nbsp;Age: you can be specific or just put the range (20s, 30s, 40s, 50s, etc.)&nbsp;</font></td><td width="50%" bgcolor="#F8F9FD"><input type="text" name="age" size="20" maxlength="65"> </tr> <tr> <td width="50%" align="right"><font face="Verdana" size="2"><font color="#800000"><b>*</b></font>&nbsp;</font><font face="Verdana" size="2">what is the name of your church &amp; what is the denominational affiliation?&nbsp;</font></td><td width="50%" bgcolor="#F8F9FD"><textarea cols="30" rows="4" name="pastor_explain"></textarea> </tr> <tr> <td width="50%" align="right"><font face="Verdana" size="2"><font color="#800000"><b>*</b></font>&nbsp;What is the size of your <i>attending </i>congregation on a typical Sunday morning &amp;</font> <font face="Verdana" size="2">the age range of most of the members (20s, 30s, 40s, 50s, 60s, etc.)?</font></td><td width="50%" bgcolor="#F8F9FD"><textarea cols="30" rows="4" name="bible_college_explain"></textarea> </tr> <tr> <td width="50%" align="right"><font face="Verdana" size="2"><font color="#800000"><b>*</b></font>&nbsp;Have you read any of <a href="http://www.ptmin.org/books">Frank's books</a>?</font></td><td width="50%" bgcolor="#F8F9FD"><select name="Reimagining"> <option value="1" SELECTED>choose one</option> <option value="yes_reimagining">yes</option> <option value="no_reimagining">no</option> </select> </tr> <tr> <td width="50%" align="right"><font face="Verdana" size="2"><font color="#800000"><b>*</b></font>&nbsp;Have you heard any of <a href="http://www.ptmin.org/audio-mp3s">Frank's spoken messages</a>?</font></td><td width="50%" bgcolor="#F8F9FD"><select name="Pagan"> <option value="1" SELECTED>choose one</option> <option value="yes_pagan">yes</option> <option value="no_pagan">no</option> </select> </tr> <tr> <td width="50%" align="right"><font face="Verdana" size="2">Please press Submit only once.<br><u><i>Thank you.</i></u></font></td> <td width="50%" bgcolor="#F7F8FC"><input type="submit" value="Submit"><input type="reset" value="Reset"></td> </tr> </table> <p align="center"> <br> <a href="http://www.ptmin.org">Return to Present Testimony Ministry</a> </div> </div> </div> </div> </div> </body> </html>