SPIDIR Referral Please fill out the form below. Alternatively, you can download and complete the enquiry form and email it to firstname.lastname@example.org. Step 1 of 7 14% Name & AddressName* TitleMrMrsMissMsDrProf.Rev. Title First Last Address Street Address Address Line 2 City County Post Code Contact DetailsEmail* Home NumberMobile NumberWork NumberPreferred Phone NumberIf we need to discuss your referral request please indicate how you would prefer us to contact you.HomeMobileWorkEmail Personal DetailsAge*Please enter a value greater than or equal to 16.Gender*MaleFemaleMarital Status More About YouOccupation*Church Attended*Do you hold any leadership/ministry position in your church?*How did you come to contact SPIDIR?What would you hope to get from Spiritual direction?*What are you looking for?Have you had a spiritual director or companion before?*YesNo Further InformationIf yes, tell us something about your experienceWhat are your interests outside your working life?Special interestsAre there things that specially interest you in the areas of theology/ spirituality/ ministry/ prayer?Please outline anything else that might help us Spiritual Director PreferencesDo you have preferences as to the Spiritual companion you would like to see?Gender*MaleFemaleNo PreferenceOrdained*OrdainedLayNo PreferenceDenominationWe are an ecumenical – directors/companions come from a broad spectrum of church life. How important to you is the church background/ denomination of your director? If it is important, please specify. TravelHow and how far can you travel?TransportCarPublic TransportDistance (miles)PhoneThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.