Harvest House Ministries
Entrance Interview

The following 9 pages contain our Harvest House entrance interview. Please complete this form in its entirety. Upon completion, your information will be securely sent to our staff. We will review your information and contact you regarding your acceptance.

Highlighted field names indicate required fields.

Part 1 of 9

Date:
Name:
Age:	(Numbers only)
Street Address:
City, State, Zip:
Phone (Home):		Phone (Cell):
Email Address:
Social Security Number:
Financial Status:
Currently employed?	Yes : No	For how long?
Yes - where?		No - why not?
If ADC, what country:
Total monthly wages or your total grant amount:
How much money do you have left for the month?
What is your monthly rent amount?
Workers Name:		Workers Phone:

Harvest House MinistriesEntrance Interview

Harvest House Ministries
Entrance Interview