Husbands Name *
Husbands Last Name *
Wifes Name *
Wifes Last Name
E-mail Address: *
How did you hear about TLH?
What are your childrens names and ages? (first names only, please)
Do you view children as a blessing? *
What does the scriptures mean that the man is the head of the household? Husbands Response: *
Wifes Response *
What are your convictions in regard to birth control? Husbands Response:
Wifes Response: *
Is sterilization a sin? Husbands Response: *
Wifes Response: *
Who was sterilized? *
Why were you sterilized? When? *
What does bearing one anothers burdens mean to both of you? Husbands Response: *
Wifes Response: *
What does first fruit offering mean to both of you? Husbands Response: *
Wifes Response: *
Are you willing to donate regularly to one of the reversal fund? *
Do you belong to any other reversal ministry or groups? If so which ones? *
Are you currently on any other funding lists? *
Are you seeking financial assistance? *
Do you have any thing you need prayer about? *
What would like your password to be for the Lords Heritage Discussion List? *
Will you participate in the discussion forum regularly? *
Do you prefer digest or emails? *	Digest Emails
Street Address *
Address2: *
City: *
State: *
Zip Code/ Postal code: *
Home phone: *
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