. CHURCH AFFILIATION
      List the name of the church which you are a member or attend
__________________________________________(_____)___________
Name of Church Senior Pastor Phone

Address City State Zip

Years Attended Position(s) Held

  1. YOUR MINISTRY

Briefly explain when, how, and why you are called to ministry ___________________________________________________________________________________________________
___________________________________________________________________________________________________
If you are involved in a Christian ministry, please answer the following.
_______________________________________________________________Name of Ministry
 Address
                _________________________________________________________ Phone _____________________________
 
               _______________________________________________________________
                            
Years Involved Position(s) Held

_____________________________________(____)_____________________
Head of Ministry Phone

Previous Ministry Experience

_________________________________________________________
Dates Ministry Duties Reason for leaving

___________________________________________________________
Dates Ministry Duties Reason for leaving

(Use back of this sheet if you need to add more)

Are you or have you ever been licensed or ordained? ____Yes ____No
If Yes, list the denomination/organization, date credentialed, and what state and county filed:

Have you ever been disciplined or removed from a ministry position for any reason? (e.g., insubordination, ethical violations, or moral failure?) ___Yes ___No
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