Penn York DBMD 01 - Personal Data Inventory
This inventory is designed to introduce you to your district board of ministerial development (DBMD) and inform them concerning your present situation as you apply for district ministerial standing. You are expected to fill out the inventory frankly and carefully in order that the DBMD might know you and your background better and thereby assist you in your progress toward ministerial credentials. It is your responsibility to answer all questions as they apply to your situation.
Identification Data
Full Name
*
Prefix
First Name
Middle Name
Last Name
Suffix
Email Address
*
example@example.com
Gender
*
Female
Male
Birthdate
*
-
Month
-
Day
Year
Date
Mailing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Physical Address (if different than mailing)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Cell Phone Number (if applicable)
-
Area Code
Phone Number
Home Phone Number (if applicable)
-
Area Code
Phone Number
Are you a legal citizen of the United States?
*
Yes
No
If you are not a legal US citizen, please explain.
Military record (if applicable)
Family Relationships
How many children are in your parent's family?
*
Which position are you?
*
Briefly survey your childhood home environment, parents' relationship to each other, affection in the home, and your religious training/upbringing.
*
Are your parents living?
*
Father
Mother
Both
Father's full name
*
First Name
Last Name
Mother's full name
*
First Name
Last Name
Parent status
*
Married
Divorced
Remarried
Are your parents professing Christians
*
Father
Mother
Both
Which denomination is each a member (if any)?
*
What is your family's attitude toward the prospect of you entering the ministry?
*
1
2
3
4
5
Supportive
Opposed
1 is Supportive, 5 is Opposed
Marital Status
Current status
*
Single
Dating
Engaged
Married
Widow(er)
Divorced
If 'single', or 'dating' are you contemplating marriage?
If engaged, what is the planned date of marriage?
If engaged, please list fiance's name, birth date, and SSN
Is your fiance a citizen of the United States?
Yes
No
If no, please explain
Explain any hesitancy or resistance your spouse or fiance may have with your desire to become a minister.
If married, please list spouses name and birthdate
Is your spouse a citizen of the United States?
Yes
No
If no, please explain
Date of marriage
-
Month
-
Day
Year
Date
Spouse's education
Are you and your spouse maintaining a life of sexual purity and faithfulness in your marriage covenant?
Yes
No
Have you or your spouse ever been involved in sexual activity with a minor?
*
Yes
No
Are you now living with your spouse?
Yes
No
If not, please give explanatory statement.
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Have you or your spouse been divorced?
Yes
No
If so, please give explanatory statement.
Have you or your spouse had a previous marriage terminated by death?
Yes
No
If so, please give date and other information which might help the DBMD understand your situation and loss.
Is your spouse currently employed?
Yes
No
If so, please list his/her position(s)
Does your spouse plan to continue employment after you are engaged in active ministry?
Yes
No
Maybe
If so, what type of employment?
Does your spouse profess to be converted?
Yes
No
Does your spouse profess to be entirely sanctified?
Yes
No
Is there any hesitance or problem that you know of at this time which might affect your ability to serve effectively?
List the ways your spouse might contribute to and/or complement your ministry.
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Family Dependents
Number of children
Please list children's names, genders, birth dates, whether they're currently living as your legal dependent, etc.
Other dependents
Health Information
Do you have chronic illnesses or physical defects?
*
Yes
No
If so, please state the nature of these.
Have you ever had any serious illness(es)?
*
Yes
No
If yes, please state the nature of the serious illness(es)
Have you ever had any serious emotional problem(s)?
*
Yes
No
If yes, please state the nature of the emotional problem(s)
What do you consider your present state of health to be?
*
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Other Personal Data
Give names of all patriotic, civic, social, fraternal, or athletic societies to which you currently belong or have belonged.
*
Have you ever been a member of any organization commonly considered politically subversive?
*
Yes
No
If yes, please give explanatory statement.
Have you ever been a user of tobacco, alcohol, or other harmful drugs?
*
Yes
No
If yes, explain how you were delivered from such uses
What is your attitude toward the above practices or other personal habits which are injurious physically or hurtful to one's influence?
*
Have you ever been convicted of, or pled guilty or "no contest" to, any criminal offense?
*
Yes
No
If yes, explain fully by identifying each conviction or plea of guilt, when and where each incident occurred, and the sentence(s) received.
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Employment and Finances
Give your employment record, listing the places where you have worked (begin with the most recent), including the name and address of the employer, the position(s) you held, and the dates employed.
Have you ever been dismissed from a job (other than laid off due to lack of available work)?
*
Yes
No
If yes, what was the job and the reason(s) for your dismissal?
If you are currently unemployed, upon whom are you dependent?
Have you held a position where you had to plan your own time?
*
Yes
No
If yes, what position?
Have you ever been in a position where others were under your supervision?
*
Yes
No
If yes, what position?
List the total amount of indebtedness you presently have.
*
What is the amount necessary per month to serve your debt?
*
Are you presently or have you ever been in arrears on repayment of any debt or obligation?
*
Yes
No
If yes, please explain
Could your financial obligations, in any way, interfere with your influence as a minister?
*
Yes
No
If yes, please explain
Will you make every effort to assure that your lifestyle will not be marred nor bring reproach to the gospel, either by your personal obligations or your lifestyle?
*
Yes
No
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Educational Record
High School - (name(s), dates attended, degree or certificate)
*
If you have a high school equivalency diploma, give number and year of issue
College - (name(s), dates attended, degree or certificate)
*
Seminary or Graduate School - (name(s), dates attended, degree or certificate)
*
Other
*
Are you now enrolled or do you plan to enroll in one of our Wesleyan colleges or one of the approved seminaries?
*
Yes
No
Have you completed any part of the pre-ordination/commissioning courses or study?
*
Yes
No
If yes, which course(s)?
Are you aware of the academic requirements for ordination/commissioning and if licensed by this district, is it your purpose to pursue immediately the course(s) of study and be ordained/commissioned?
*
Yes
No
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Religious Experiences and Church Relationship
Name the church(es) you have attended up to the present time.
*
Of which local Wesleyan church are you currently a member?
*
How long have you held membership in that church?
Is your spouse or fiance a member of a Wesleyan church?
*
Yes
No
If not, in what church does he/she hold membership?
Describe the relationships which have existed between you and your local church(es).
*
When were you converted?
*
Describe your Christian development to the present time.
*
When were you baptized?
*
Are you entirely sanctified?
*
Yes
No
If not, will you seek this experience and walk in the light God reveals regarding this experience?
*
Yes
No
Have you ever resigned from, or been dismissed by, any ministerial position with any church or religious institution?
*
Yes
No
If yes, explain fully by describing when and where each resignation or dismissal occurred, and the basis for each such case.
Do you feel a definite call to the Christian ministry?
*
Yes
No
Describe how you were called.
*
Is it your goal to make the ministry your life's work?
*
Yes
No
Do you feel led to any specific type of ministry at this time?
*
Describe your personal habits in the matter of Bible reading and prayer.
*
Describe your practice of personal evangelism.
*
Describe your involvement in the lives of others which is producing spiritual growth on their part.
*
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Do you believe in, and are you practicing storehouse tithing as defined in Discipline 465? ["Storehouse tithing is a scriptural and practical performance of faithfully and regularly placing the tithe into that church to which the member belongs. Therefore, the financing of the church shall be based on the plan of storehouse tithing, and The Wesleyan Church shall be regarded by all its people as the storehouse. All who are a part of The Wesleyan Church are urged to contribute faithfully one-tenth of all their increase as a minimum financial obligation to the Lord and freewill offerings in addition as God has prospered them."]
*
Yes
No
Have you read, and do you fully subscribe to, the Articles of Religion of The Wesleyan Church as found in the Constitution? (see the Articles of Religion in paragraphs 210-250 of the Discipline)?
*
Yes
No
State any reservations you may have at this time.
*
What reservations might you now have in enforcing any of the above Membership Commitments in a local church where you may serve? (Membership Commitments are found in the Discipline at paragraph 265)
*
Can you support the entire Church with her departments and institutions?
*
Yes
No
Have you read, and do you govern your personal life by The Membership Commitments of The Wesleyan Church?
*
Yes
No
State any reservations you have.
What experience have you had in preaching?
*
What office(s) have you held in the local church? (Sunday school, Wesleyan youth, etc)
*
Are you prepared to report regularly to the district?
*
Yes
No
Describe any hesitancy you may have in accepting the authority, discipline, nurture, and guidance of the district board of ministerial development (DBMD) in regard to evaluating your gifts, graces, and usefulness as you work toward ordination/commissioning.
*
Describe your call to ministry.
*
Why have you chosen to minister as a part of the Wesleyan Church?
*
Have you ever been a ministerial student or licensed minister in another denomination or local church?
*
Yes
No
If yes, please explain the circumstances under which you left the previous denomination/church
The Wesleyan Church believes that God calls both men and women into ordained/commissioned ministry. Will you support this position?
*
Yes
No
In what year do you anticipate you will be ready to be ordained/commissioned?
*
If you have a file you desire to upload, you may do so here.
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Closing Statement & Signature
Please enter your initials after each of the following statements. Your initials serve as your digital signature of this form.
I understand that ordination/commissioning by The Wesleyan Church is a privilege granted me, not a right that I claim. I hereby acknowledge the authority of the Church in granting ordination/commissioning to those who, after thorough examination, are believed to have the gifts, graces, fruit and call of God. Further, I understand that though I may complete all of the academic requirements for ordination, it does not guarantee my ordination/commissioning.
*
I hereby freely give permission for the use of this information by the district and general officials of The Wesleyan Church and waive my right to examine any confidential information about me provided by other persons.
*
Please enter your full name as a secondary digital signature before submitting this completed form
*
Date this form was completed
*
-
Month
-
Day
Year
Date
Signature
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