HNI Partner Application HarvestNet International Partner Application If you have any questions about this application, email firstname.lastname@example.org. We urge you to be honest in your responses. 1 Contact Information2 Spiritual Life3 General Information4 Credentialing5 Commitments6 Payment & Signature Application Date:*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Choice of Partnership Level*SelectOrganizationalIndividualOrganizational Partners*SelectChurch or MinistryMarketplaceIndividual Partners*SelectAssociateDescribe your ministry, church, or business and its vision:*Contact Information:Please complete this section in its entirety. Name* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Home Email* Home or Mobile Phone*Home or Mobile Phone*Organization Name*Organization Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Office Email* Office Phone*Name of Spouse (if applicable)*Email of Spouse (if applicable)*Phone number of Spouse (if applicable)* Spiritual Life:Please complete this section in its entirety. Home Congregation*Pastor's Name*Church Phone:*Are you a member?*YesNoHow Long have you attended there?*What spiritual gifts do you see at work in your life?*(evangelism, serving, teaching, prophetic ministry, etc.)Do you currently have a spiritual parent/mentor or overseer?*YesNoIf yes, please list their names.*Please provide the name of at least one HNI partner, you are actively in relationship with.* General Information:Please complete this section in its entirety. Why are you (or your organization) interested in joining HarvestNet International?*What is your (or your organization) mission statement?*Do you (or your organization) have a budget?*YesNoBudget Explanation Method*Text FieldFile UploadDescribe Your Budget*Upload Your BudgetPlease convert files to PDF for uploadAccepted file types: pdf.What are the three (3) most significant resources you (or your organization) have to offer to the other HNI partners?*What do you believe are the three (3) most significant ways HNI partners could assist you in fulfilling your mission?*Are there any specific HNI partners you envision forming significant personal or ministry relationships with?*Since HarvestNet is a partnership to fulfill the great commission, please describe your involvement in evangelism or missions*Describe the current state of health of yourself (your organization):*Are there current needs that you (your organization) would desire someone from with in the HarvestNet International family to assist you with in the next 12-18 months?*Do you (or your organization) have 501c3 status?*YesNoHarvestNet International's liability insurance does not cover partners, their ministries, or businesses. Are you covered by a liability insurance policy?*YesNo Credentialing:Please complete this section in its entirety. Are you currently licensed or ordained?*YesNoIf Yes, with whom? Will you be maintaining relationship with that credentialing body or seeking to transfer your credentials to HNI?*If No, is licensure or ordination something that you desire to pursue?*YesNo CommitmentsPlease complete this section in its entirety. Have you read and understood the entire HNI Partner Handbook?*YesNoClick Here to view the HNI Partner HandbookDo you agree to fulfill the commitments and expectations of HNI partners outlined in the HNI Partner Handbook?*YesNoWill you support and serve as an ambassador for HNI within your sphere of influence?*YesNoHarvestNet International currently has no fee for membership; however, each partner is simply asked to give generously to support the work of the network, as they are able. When possible, set monthly contributions work best and can be altered at any time.Will you (your church, ministry, or business) contribute generously, with finances and other resources, to Harvest Net as the Lord gives you means? HNI suggests and encourages U.S. Partners to give approximately 1-2% to HarvestNet International.*YesNoDid you give your permission for HNI to publish your name, church/ministry/ business name, address, phone number, and website details on the HarvestNet International website or other HNI publications?*YesNoDo you give your permisiion for HNI to use your photograph in promotional materials or communication related to HNI and its ministries?*YesNoPlease upload the photo you would wish HarvestNet International to use.Please upload only high resolution photos. Thank you. Application Fee* Price: $10.00 Credit Card American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20172018201920202021202220232024202520262027202820292030203120322033203420352036 Expiration Date Security Code Cardholder Name Total $0.00 Electronic Signature:Electronic Signature RequiredYour Electronic Signiture*Date*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Spouse Electronic SignatureDateMonth123456789101112Day12345678910111213141516171819202122232425262728293031Year201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920NameThis field is for validation purposes and should be left unchanged. 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