Pastor Application Form
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Personal Information
First Name
Last Name
Email
Address
How long
Date of Birth
Telephone: Home
Business
Telephone: Mobile
Personal website address (if available)
If hired, can you present proof of your legal right to live and work in this country?
Yes
No
N/A
No. of years lived in the US
Martial Status
Married
Separated
Divorced
Widowed
Single
If married, Name of Spouse
Is this your first spouse?
Yes
No
Name and ages of children
Are you ordinated?
Yes
No
Date and place of Ordination
Denomination
Have you been baptized by immersion?
Yes
No
If you have not been baptized by immersion, would you consider being baptized by immersion?
Yes
No
Have you ever filed for bankruptcy?
Yes
No
If Yes, please state the nature and circumstances of the bankruptcy
have you ever been convicted of a felony
Yes
No
If Yes, please state the nature of the crime(s), when and where convicted and disposition of the case:
Educational Background
Name of the college/university
Location of the college/university
No. of years completed in college/university
Major & Degree in college/university
Name of Vocational or Technical school
Location of Vocational or Technical school
No. of years completed in Vocational or Technical school
Major & Degree from Vocational or Technical school
Name of graduate school
Location of graduate school
No. of years completed in graduate school
Other School
Location of other school
No. of years completed in other school
Major & Degree from Other school
Additional Academic Experience (post secondary). Please list courses attempted and whether or not completed; P/T or F/T; dates; institutions and awards received.
Please briefly describe your general background: summarize your ministry strengths and weaknesses; ministry preferences and vision; and your special interests in ministry
Are you presently being investigated or under a procedure to consider your discharge for misconduct by your present employer?
Yes
No
Has any employer ever subjected you to disciplinary action, suspended, terminated, or asked you to leave a job or volunteer position on the grounds of any unlawful sexual behavior, or violation of an employer's sexual misconduct or harassment policy
Yes
No
Have you ever been charged in civll or criminal proceedings with improprieties regarding children's
Yes
No
Have you ever entered a plea of guilty, a plea of “no contest“ (nalo contendere) or has any court ever deferred further proceedings without entering a finding of guilty and placed you on probation or in a public service or education program for any crime
Yes
No
Have you ever been suspended, discharged, or resigned in lieu of discharge from any position
Yes
No
Work Experience
Name of the employer 1
Name of the last supervisor 1
Address of the employer 1
Employment start date
Employment end date
Your last job title
Reason for leaving (be specific):
May we contact this employer for a reference?
Yes
No
Name of employer 2
Name of last supervisor 2
Address of the employer 2
Employment start date
Employment end date
your last job title
Reason for leaving (be specific):
May we contact this employer for a reference?
Yes
No
Name of employer 3
Name of the last supervisor 3
Address of the employer 3
Employment start date
Employment end date
your last job title
Reason for leaving (be specific):
May we contact this employer for a reference?
Yes
No
Name of employer 4
Name of the last supervisor 4
Address of the employer 4
Employment start date
Employment end date
your last job title
Reason for leaving (be specific):
May we contact this employer for a reference?
Yes
No
Leadership Roles
Leadership of a church involves several roles. Consider the following list (Note up to five.)
General Pastoral Care
Oversight and coordination of day-to-day operations of the church
Preaching
Management and Administration
Youth Ministry Training Counseling Teaching and Mentoring. Outreach to the wider community
Support and oversight of staff and volunteers (leaders and coordinators of various activities)
Collaborative decision making in boards or committees
Personal professional development
Networking facilitating partnerships promoting unity
In which of these you are strongest? Explain
In which of these you are weakest? Explain
What evidence is there to confirm that you have strengths in these?
What evidence is there that you are able to operate cross culturally and be at home in a multi-cultural community? What experience have you had in a multi-cultural community?
Three references who are qualified to speak of your spiritual experience and Christian service
Name of the person 1
Address of the person 1
Phone number of the person 1
Position of the person 1
Name of the person 2
Address of the person 2
Phone number of the person 2
Position of the person 2
Name of the person 3
Address of the person 3
Phone number of the person 3
Position of the person 3
Three references who are qualified to speak of your professional training and experience
Name of the person 1
Address of the person 1
Phone number of the person 1
Position of the person 1
Name of the person 2
Address of the person 2
Phone number of the person 2
Position of the person 2
Name of the person 3
Address of the person 3
Phone number of the person 3
Position of the person 3
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