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Editor's note: This document appears here unedited.
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BUDDY REPORT


Date of Entry:

Filed by:


Buddy Name:

Age/Birth date:

Address:

Phone: (H/W)

Religious Affiliation:

Faithful Attendance? Y N

Spouse's religious affiliation:

F(aithful) Attendance? Y N


Occupation:

Place of Employment (Current):

Pertinent Work History:


Educational History:


Health Information: Rate physical health (check one): Very good____Good____
Average____Declining____Other____Specify:_____________

Significant Past History (Severe Illnesses, handicaps. allergies, medications, etc)

Other Current (Sensitive to stress, frequent headaches, stomach problems, etc)

Introduced to MOG How/When?

Past religious affiliation (if changed):

Pre-MOG Religious experiences:

Any involvement with cults?


Data on Healings or Healings Needed:

Fears/Hurts:

Previous Marriage? (Broken how? divorce/death)

Other (Stability/discipline/nervousness/complacency/moral man, etc)

Family History:

Own family:

Spiritual Life:

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