<!-- BOF: ./personal-templates/show.body -->
<!-- BOF: ./personal-templates/simple/generic/show -->
<!-- BOF: ./personal-templates/rtl.html -->
<!-- Locale=en_US -->
<!-- EOF: ./personal-templates/rtl.html -->


<!-- BOF: ./personal-templates/simple/generic/functions -->
<!-- BOF: ./personal-templates/simple/generic/navbar --><!-- EOF: ./personal-templates/simple/generic/navbar -->


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<!-- BOF: ./personal-templates/simple/personal/other/l50.settings.init -->


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  <!-- BOF: ./personal-templates/simple/business/layout/l57.wait -->


<!-- EOF: ./personal-templates/simple/business/layout/l57.wait -->


<HTML>

<HEAD>


<META NAME="description" CONTENT="Family Counseling Associates - a Christ-centered Professional Counseling Center in Indianapolis, Indiana (317) 585-1060">
<META NAME="Keywords"    CONTENT="counseling, therapy, christian, marriage, family, depression, marital, family counseling associates, Tim Heck, Jama Davis, catholic, indianapolis, therapists">


<!-- business -->


<META HTTP-EQUIV="Content-Type" CONTENT="text/html; charset=UTF-8">
<META NAME="Generator" content="">
<!-- BOF: ./personal-templates/simple/themes.show -->


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<!--<BASE HREF="http://proteus.meccahosting.com/~a00043dd/form7.html">-->
<TITLE>Deacon Application</TITLE></head>
<BODY  BGCOLOR="#FFFFFF"
 TEXT="#333333"

LEFTMARGIN="0" TOPMARGIN="0" RIGHTMARGIN="0" BOTTOMMARGIN="0"

 onLoad=""
 
 LINK="#000000"
 VLINK="#000000"
 ALINK="#000000"
>

  
      <!-- BOF: ./personal-templates/simple/business/layout/l57.layout --> 

<!-- html -->
<TABLE WIDTH="100%" height="100%" BORDER=0 CELLPADDING=0 CELLSPACING=0>
  <tr>
     <td width="5%" bgcolor="#999999">
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                               <td valign="top" width="100%" height="70">
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                                              <tr>
                                                 <td colspan="2" height="9" background="widgets/gen_2788.1.gif" valign="top"></td>
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                                                 <td width="100%" background="widgets/gen_2778.1.gif"><img src="widgets/gen_2792.1.gif" border=0 width=245 height=24 alt=""></td>
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                            </tr><!-- End top -->
                            <tr>
                               <td><!-- body & buttons -->
                                           <table width="100%" height="100%" border="0" cellpadding="0" cellspacing="0">
                                              <tr>
                                                <td bgcolor="#F4F4F4" width="197" height="100%" valign="top">
                                                          <table width="197" height="100%" border="0" cellpadding="0" cellspacing="0" valign="top">
                                                          <tr><td valign="top" height="100%">
                                                          <table width="197" height="100%" border="0" cellpadding="0" cellspacing="0" valign="top">
                                                             <tr>
                                                                <td width="6" background="widgets/gen_2784.1.gif" valign="top"><img src="widgets/gen_2779.1.gif" border=0 width=6 height=7 alt=""></td>
                                                                <td width="191" valign="top">
                                            <a href="index.html" onMouseOver="document.images['img246'].src='widgets/gen_2796.1.gif'" onMouseOut="document.images['img246'].src='widgets/gen_2795.1.gif'"><img src="widgets/gen_2795.1.gif" alt="Welcome" name="img246" border="0"></a><br>
                                            <a href="gpage1.html" onMouseOver="document.images['img158'].src='widgets/gen_2798.1.gif'" onMouseOut="document.images['img158'].src='widgets/gen_2797.1.gif'"><img src="widgets/gen_2797.1.gif" alt="FCA North" name="img158" border="0"></a><br>
                                            <a href="gpage.html" onMouseOver="document.images['img156'].src='widgets/gen_2800.1.gif'" onMouseOut="document.images['img156'].src='widgets/gen_2799.1.gif'"><img src="widgets/gen_2799.1.gif" alt="FCA West" name="img156" border="0"></a><br>
                                            <a href="news.html" onMouseOver="document.images['img305'].src='widgets/gen_2802.1.gif'" onMouseOut="document.images['img305'].src='widgets/gen_2801.1.gif'"><img src="widgets/gen_2801.1.gif" alt="Conferences" name="img305" border="0"></a><br>
                                            <a href="form3.html" onMouseOver="document.images['img307'].src='widgets/gen_2804.1.gif'" onMouseOut="document.images['img307'].src='widgets/gen_2803.1.gif'"><img src="widgets/gen_2803.1.gif" alt="Registration" name="img307" border="0"></a><br>
                                            <a href="about1.html" onMouseOver="document.images['img149'].src='widgets/gen_2806.1.gif'" onMouseOut="document.images['img149'].src='widgets/gen_2805.1.gif'"><img src="widgets/gen_2805.1.gif" alt="Psychiatrists" name="img149" border="0"></a><br>
                                            <a href="about2.html" onMouseOver="document.images['img150'].src='widgets/gen_2808.1.gif'" onMouseOut="document.images['img150'].src='widgets/gen_2807.1.gif'"><img src="widgets/gen_2807.1.gif" alt="Marriage & Family" name="img150" border="0"></a><br>
                                            <a href="about3.html" onMouseOver="document.images['img151'].src='widgets/gen_2810.1.gif'" onMouseOut="document.images['img151'].src='widgets/gen_2809.1.gif'"><img src="widgets/gen_2809.1.gif" alt="Counselors" name="img151" border="0"></a><br>
                                            <a href="about5.html" onMouseOver="document.images['img153'].src='widgets/gen_2812.1.gif'" onMouseOut="document.images['img153'].src='widgets/gen_2811.1.gif'"><img src="widgets/gen_2811.1.gif" alt="Coaching" name="img153" border="0"></a><br>
                                            <a href="about4.html" onMouseOver="document.images['img152'].src='widgets/gen_2814.1.gif'" onMouseOut="document.images['img152'].src='widgets/gen_2813.1.gif'"><img src="widgets/gen_2813.1.gif" alt="School Counselors" name="img152" border="0"></a><br>
                                            <a href="about6.html" onMouseOver="document.images['img175'].src='widgets/gen_2816.1.gif'" onMouseOut="document.images['img175'].src='widgets/gen_2815.1.gif'"><img src="widgets/gen_2815.1.gif" alt="Interns/Residents" name="img175" border="0"></a><br>
                                            <a href="form1.html" onMouseOver="document.images['img117'].src='widgets/gen_3067.1.gif'" onMouseOut="document.images['img117'].src='widgets/gen_3066.1.gif'"><img src="widgets/gen_3066.1.gif" alt="Intake Form (NOT AVAIL 1-5-09 TO 1-19-09)" name="img117" border="0"></a><br>
                                            <a href="Download.html" onMouseOver="document.images['img93'].src='widgets/gen_2820.1.gif'" onMouseOut="document.images['img93'].src='widgets/gen_2819.1.gif'"><img src="widgets/gen_2819.1.gif" alt="Forms" name="img93" border="0"></a><br>
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                                            <a href="gpage3.html" onMouseOver="document.images['img550'].src='widgets/gen_2824.1.gif'" onMouseOut="document.images['img550'].src='widgets/gen_2823.1.gif'"><img src="widgets/gen_2823.1.gif" alt="Research" name="img550" border="0"></a><br>
                                            <a href="form2.html" onMouseOver="document.images['img266'].src='widgets/gen_2826.1.gif'" onMouseOut="document.images['img266'].src='widgets/gen_2825.1.gif'"><img src="widgets/gen_2825.1.gif" alt="Register" name="img266" border="0"></a><br>
                                            
                                            <a href="form.html" onMouseOver="document.images['img10'].src='widgets/gen_2890.1.gif'" onMouseOut="document.images['img10'].src='widgets/gen_2829.1.gif'"><img src="widgets/gen_2829.1.gif" alt="Test Your Marriage" name="img10" border="0"></a><br>
                                            <a href="links.html" onMouseOver="document.images['img36'].src='widgets/gen_2832.1.gif'" onMouseOut="document.images['img36'].src='widgets/gen_2831.1.gif'"><img src="widgets/gen_2831.1.gif" alt="Testing" name="img36" border="0"></a><br>
                                            <a href="amazon.html" onMouseOver="document.images['img197'].src='widgets/gen_2891.1.gif'" onMouseOut="document.images['img197'].src='widgets/gen_2833.1.gif'"><img src="widgets/gen_2833.1.gif" alt="Books" name="img197" border="0"></a><br>
                                            <a href="Download1.html" onMouseOver="document.images['img104'].src='widgets/gen_2836.1.gif'" onMouseOut="document.images['img104'].src='widgets/gen_2835.1.gif'"><img src="widgets/gen_2835.1.gif" alt="Articles" name="img104" border="0"></a><br>
                                            <a href="directions.html" onMouseOver="document.images['img9'].src='widgets/gen_2838.1.gif'" onMouseOut="document.images['img9'].src='widgets/gen_2892.1.gif'"><img src="widgets/gen_2892.1.gif" alt="Directions" name="img9" border="0"></a><br>
                                            <a href="faq.html" onMouseOver="document.images['img106'].src='widgets/gen_2840.1.gif'" onMouseOut="document.images['img106'].src='widgets/gen_2839.1.gif'"><img src="widgets/gen_2839.1.gif" alt="FAQ" name="img106" border="0"></a><br>
                                            <a href="links1.html" onMouseOver="document.images['img178'].src='widgets/gen_2842.1.gif'" onMouseOut="document.images['img178'].src='widgets/gen_2841.1.gif'"><img src="widgets/gen_2841.1.gif" alt="Internet Links" name="img178" border="0"></a><br>
                                            
                                            
                                            <a href="links2.html" onMouseOver="document.images['img566'].src='widgets/gen_2877.1.gif'" onMouseOut="document.images['img566'].src='widgets/gen_2868.1.gif'"><img src="widgets/gen_2868.1.gif" alt="Deacon Assessment" name="img566" border="0"></a><br>
                                            <a href="mailto:gayle@fcahelp.com" onMouseOver="document.images['img_email'].src='widgets/gen_2854.1.gif'" onMouseOut="document.images['img_email'].src='widgets/gen_2853.1.gif'"><img src="widgets/gen_2853.1.gif" alt="e-mail me" name="img_email" border="0"></a><br></td>
                                                             </tr>
                                                          </table>
                                                          </td></tr>
                                                          
                                                          <tr><td valign="bottom" height="183" width="197"><img src="widgets/gen_2783.1.gif" border=0 width=197 height=183 alt=""></td></tr>
                                                          
                                                          </table>
                                                </td>
                                                <td valign="top"><!-- BOF: ./personal-templates/simple/business/form/html -->
<!-- BOF: ./personal-templates/simple/personal/form/html -->


<center><table border=0>
<tr><td>


<font face='Arial' size='+1' color='#588D58'>

Deacon Application

</font>


<br>
<SCRIPT LANGUAGE="JavaScript">
var BUILDER = '/servlet/psoft.masonry.Builder';
function validate(frm){
var i = 0;

if (frm.field_571.value=="") return error(frm.field_571);

if (frm.field_572.value=="") return error(frm.field_572);

if (frm.field_574.value=="") return error(frm.field_574);

if (frm.field_575.value=="") return error(frm.field_575);

if (frm.field_576.value=="") return error(frm.field_576);

if (frm.field_579.value=="") return error(frm.field_579);

var url = document.URL;
if (url.indexOf(BUILDER) == -1 && url.charAt(url.length)!='/') {
    url = url.substring(0, url.lastIndexOf('/')+1);
}
frm.domain.value=url;
return true;
}
function error(field){ alert('You did not fill all required fields!'); field.focus(); return false; }
</SCRIPT>
<form name="questionary" action="http://66.135.32.28:8080/servlet/psoft.customform.CustomForm" method="post">
<input type="hidden" name="domain" value="">
<input type="hidden" name="title" value="Deacon Application">
<input type="hidden" name="esubj" value="Submitted Application">
<input type="hidden" name="name" value="=GCh0WG5bU1bal4b">
<input type="hidden" name="submit_url" value="onsubmit9.html">
<input type="hidden" name="error_url"  value="onerror9.html">
<input type="hidden" name="order" value="571 572 573 574 575 576 577 578 579 580 ">
<table border=0 cellpedding=5 cellspacing=5>

<input type="hidden" name="name_571" value="First Name of Deacon Candidate">
<tr><td>


<font face='Arial' size='2' color='#333333'>

First Name of Deacon Candidate

</font>


 <font color="red" size="-1">*</font></td><td>


<input type="text" name="field_571" size="15">


</td></tr>

<input type="hidden" name="name_572" value="Last Name">
<tr><td>


<font face='Arial' size='2' color='#333333'>

Last Name

</font>


 <font color="red" size="-1">*</font></td><td>


<input type="text" name="field_572" size="20">


</td></tr>

<input type="hidden" name="name_573" value="Spouse's First Name (If Married)">
<tr><td>


<font face='Arial' size='2' color='#333333'>

Spouse's First Name (If Married)

</font>


 </td><td>


<input type="text" name="field_573" size="15">


</td></tr>

<input type="hidden" name="name_574" value="Address">
<tr><td>


<font face='Arial' size='2' color='#333333'>

Address

</font>


 <font color="red" size="-1">*</font></td><td>


<input type="text" name="field_574" size="25">


</td></tr>

<input type="hidden" name="name_575" value="City">
<tr><td>


<font face='Arial' size='2' color='#333333'>

City

</font>


 <font color="red" size="-1">*</font></td><td>


<input type="text" name="field_575" size="20">


</td></tr>

<input type="hidden" name="name_576" value="Zip">
<tr><td>


<font face='Arial' size='2' color='#333333'>

Zip

</font>


 <font color="red" size="-1">*</font></td><td>


<input type="text" name="field_576" size="5">


</td></tr>

<input type="hidden" name="name_577" value="Home Phone">
<tr><td>


<font face='Arial' size='2' color='#333333'>

Home Phone

</font>


 </td><td>


<input type="text" name="field_577" size="11">


</td></tr>

<input type="hidden" name="name_578" value="Cell Phone">
<tr><td>


<font face='Arial' size='2' color='#333333'>

Cell Phone

</font>


 </td><td>


<input type="text" name="field_578" size="12">


</td></tr>

<input type="hidden" name="name_579" value="E-Mail">
<tr><td>


<font face='Arial' size='2' color='#333333'>

E-Mail

</font>


 <font color="red" size="-1">*</font></td><td>


<input type="text" name="field_579" size="">
<input type="hidden" name="rcpt" value="field_579">


</td></tr>

<input type="hidden" name="name_580" value="Comments or Questions">
<tr><td>


<font face='Arial' size='2' color='#333333'>

Comments or Questions

</font>


 </td><td>


<textarea name="field_580" rows="8" cols="25"></textarea>

</td></tr>

<tr><td colspan=2 align=center>
    <input onClick="return validate(form)" type="submit" value="Submit">
    <input type="reset"  value="Reset">
    </td>
</tr>
</table>
</form>
</td></tr></table></center>
<!-- EOF: ./personal-templates/simple/personal/form/html -->

<!-- EOF: ./personal-templates/simple/business/form/html -->
<br>

<br>
<FONT FACE="verdana, arial, helvetica" SIZE="1">
<center>
<nobr>|<a href="index.html">Welcome</A>|</nobr>

<nobr>|<a href="gpage1.html">FCA North</A>|</nobr>

<nobr>|<a href="gpage.html">FCA West</A>|</nobr>

<nobr>|<a href="news.html">Conferences</A>|</nobr>

<nobr>|<a href="form3.html">Registration</A>|</nobr>

<nobr>|<a href="about1.html">Psychiatrists</A>|</nobr>

<nobr>|<a href="about2.html">Marriage & Family</A>|</nobr>

<nobr>|<a href="about3.html">Counselors</A>|</nobr>

<nobr>|<a href="about5.html">Coaching</A>|</nobr>

<nobr>|<a href="about4.html">School Counselors</A>|</nobr>

<nobr>|<a href="about6.html">Interns/Residents</A>|</nobr>

<nobr>|<a href="form1.html">Intake Form (NOT AVAIL 1-5-09 TO 1-19-09)</A>|</nobr>

<nobr>|<a href="Download.html">Forms</A>|</nobr>

<nobr>|<a href="catalog.html">CMFS</A>|</nobr>

<nobr>|<a href="gpage3.html">Research</A>|</nobr>

<nobr>|<a href="form2.html">Register</A>|</nobr>

<nobr>|<a href="form.html">Test Your Marriage</A>|</nobr>

<nobr>|<a href="links.html">Testing</A>|</nobr>

<nobr>|<a href="amazon.html">Books</A>|</nobr>

<nobr>|<a href="Download1.html">Articles</A>|</nobr>

<nobr>|<a href="directions.html">Directions</A>|</nobr>

<nobr>|<a href="faq.html">FAQ</A>|</nobr>

<nobr>|<a href="links1.html">Internet Links</A>|</nobr>

<nobr>|<a href="links2.html">Deacon Assessment</A>|</nobr>
</center>
</font>

<br><center>
<center><table border="0" cellpadding="0" cellspacing="3"><tr><td align="center">

<br><font face="helvetica,verdana, arial" size="1">&nbsp;</font>

</td></tr></table></center>
</center></td>
                                                <td align="right" width="32" valign="top" bgcolor="#F4F4F4">
                                                          <table width="32" height="100%" border="0" cellpadding="0" cellspacing="0">
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                                                                 <td height="100%" background="widgets/gen_2781.1.gif" valign="top"><img src="widgets/gen_2780.1.gif" border=0 width=32 height=25 alt=""></td>
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                                                              <tr>
                                                                 <td height="109" width="32" valign="bottom"><img src="widgets/gen_2782.1.gif" border=0 width=32 height=109 alt=""></td>
                                                              </tr>
                                                          </table>
                                                </td>
                                              </tr>
                                           </table>
                               </td><!-- End body & buttons -->
                            </tr>
                            <tr><!-- footer -->
                               <td height="40" valign="bottom" background="widgets/gen_2785.1.gif">&nbsp;</td>
                            </tr><!-- End footer -->
                         </table>
     </td>
     <td width="5%" bgcolor="#999999">
           <table width="100%" height="100%" border="0" cellpadding="0" cellspacing="0">
             <tr>
               <td width="25" background="widgets/gen_2777.1.gif"><img src="images/spacer.png" height="1" width="25"></td>
               <td width="100%">&nbsp;</td>
             </tr>
           </table>              
     </td>
  </tr>
</TABLE>
<!-- end html -->
                
<!-- EOF: ./personal-templates/simple/business/layout/l57.layout -->

    
<!-- BOF: ./personal-templates/simple/themes.show.body -->


<script language="javascript">
	if (document.images)
	var staticlogo=new Image()
	staticlogo.src="";
	var logolink = "index.html"
	var alttext=""

	var dist_vert=0


	var dist_hor=5;


	var fadeintoview=1;
	var fade_dur=1
;

	var visibleduration=10; 

	var placement=3;  
</script>
<script language="javascript1.2" src="widgets/staticlogo1.js"></script>

<!-- EOF: ./personal-templates/simple/themes.show.body -->

</body>
<!-- BOF: ./personal-templates/simple/themes.show.end -->


<!-- EOF: ./personal-templates/simple/themes.show.end -->


</html>


<!-- EOF: ./personal-templates/show.body -->