Certified Trainer Application Certified Trainer Application First Name Last Name Address Cell Number Email Church or Ministry Name Current Title How long have you been there? Prior ministry Which MT or CT referred you to the CT program? References Pastor Cell Number Email Spouse/ Close Friend Cell Number Email Please confirm the following by checking the boxes and then signing below: I agree to attend the Certified Trainer Retreat December 4-7, 2017. If accepted as a Certified Trainer, there will not be a registration fee for this event, but I will need to cover travel costs. If selected as a Certified Trainer, I understand that this is an annual certification with an evaluation after every year. The program starts the day that the program fee is paid. I have read and agreed to the Dare 2 Share Statement of Faith Click here to read the Dare 2 Share Statement of Faith. Signed First Name Last Name Date Need assistance with this form?