November 20, 2008                                                                                                     Quick Find ---------Site Map--------- About Us Beliefs Vision Itinerary Conferences Online Radio Broadcast Online TV Broadcast Mighty Men of Valor Virtuous Women Partnership Monthly Partner Letter Covenant Ministries Prayer Requests Steps to Salvation Daily Confessions Products Contact Us
	Title: Mr. Mrs. Miss Pastor First Name:   Last Name: Spouse Name: Address: City: State: Zip: Country: Email: Home Phone: Fax Number: Nationality: African American/Black Asian/Pacific Caucasian Hispanic Native America Other Would you like additional information on Tony and Cynthia Brazelton Ministries?   Yes   No How did you hear about us?   Do you watch or listen to the Victory Today broadcasts?   Yes   No What TV or Radio station(s) do you watch/listen to the Victory Today broadcasts on? What topic(s) are you interested in hearing or would like ministry on when you attend a TCBM conference or convention? Are you a TCBM Covenant Partner? Yes   No Do you have any additional comments? Partnership Information In order to better serve our partners and minister to your needs, we ask that you complete the following questionnaire. This information is for the sole purpose of ministering to TCBM Covenant Partners, and to give you the advantage in any ministry needs that you may have. You are not obligated to answer any question. Birthday: Month January February March April May June July August September October November December Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Your age range: 18-25 26-35 36-45 46-54 55-65 66+ Are you:   Single Married Divorced Separated Widowed Do you have children: Select One Yes No        If Yes, what are their ages? Do you have a church home? Select One Yes No        If so, Name of Church:        Name of Pastor:       Church Address:       City:   State:   Zip: Would you be interested in receiving TCBM ministry products on a weekly basis? Select One Yes No How would you like to receive TCBM ministry information? Select One Mail Email Fax How much would you like to contribute monthly as a TCBM Covenant Partner? $10 $25 $50 $100 Other $ Prayer Request Let us know your prayer request(s), and we would be happy to intercede and agree with you in prayer. Testimony Please Let us know how TCBM has been a blessing to you.