MINISTERIAL APPLICATION

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

US Citizen *

Yes

No

Sex *

Male

Female

Date of Birth *

MM

DD

YYYY

Marital Status *

Married

Single

Divorced

Separated

Spouse's Name

First Name

Last Name

Spouse's Date of Birth

MM

DD

YYYY

Anniversary Date

MM

DD

YYYY

Is your spouse a Christian? *

Yes

No

Do you have children? *

Yes

No

Pastor's Phone *

(###)

###

####

Church Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Date on which you were saved (if known)

MM

DD

YYYY

Were you raised in a Christian home? *

Yes

No

Have you been water baptized? *

Yes

No

Do you feel that you have a definite call on your life for ministry? *

Yes

No

Are you presently engaged in ministry? *

Yes

No

Have you ever been licensed or ordained? *

Yes

No

BY TYPING MY NAME BELOW IT SERVES AS MY ELECTRONIC SIGNATURE AND AGREEMENT WITH THE FOLLOWING: I understand that this application will be held in confidence and only those persons with a need to know will review it. I grant Convergence International and its leadership permission to verify the information provided on this application. I have also reviewed the Convergence International - Statement of Faith. I am in agreement with all contained within the statement or if upon any point of differing belief I agree to discuss with Convergence International leadership prior to credentialing. I hereby state that all the information contained on this application is correct and true. I understand that any misrepresentations or false statements made within this application will result in revocation of credentials. *

First Name

Last Name