Promise Land Ministries
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Break Free Today
Currently only accepting applications for adult men.
Your Name prefix, Mr or Mrs?
Online Application
Full Name
Gender
Male
Female
Age
Contact Number
E-mail Address
Education
GED / Diploma
College
Tech Shool
Veteran
Yes
No
Type of Discharge
Field of Work
Disabled
Yes
No
Health Problems
Medications
Probation
Yes
No
Charged or Convicted of Sexual Crime
Yes
No
Why Do You Want To Enter Promise Land
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