CEEC Clergy Application

DATE

Date

Title:

Such as Mr., Mrs., Rev., Dr., Pastor, etc.

Name:*

Enter First, Middle and Last

Other Names:

Address*

Street Address

Street Address Line 2

CityState

Zip CodeCountry

Home Phone:

Work Phone:

Mobile Phone:*

Email Address:*

example@example.com

Date of Birth:*

Date

Upload Photo of Applicant

Click Here To Upload Your Photo

Similar to a 2in x 2in passport photo with face clearly visible

Ever Married?*

YesNo

If so, Date of Marriage:

Date

Spouse’s Name:

If divorced, date of divorce?

Date

If divorced, on what grounds?

Did the marriage produce children?

YesNo

NAMES OF CHILDREN (please lace an asterisk {*} by the names of any children who currently reside at home)

	Name	Date of Birth
Child 1
Child 2
Child 3
Child 4
Child 5
Child 6

If divorced, who has custody?

Have you been remarried since?

YesNo

If so, what was the date of the marriage?

Date

Please provide the full name, address and telephone number of three people who have known you for at least three years, as well as their relationship to you (i.e., friend, employer, etc.) PLEASE NOTE: The Credentials Committee does not allow family members to provide references. Please include a ministerial reference; a business or work reference; and a personal reference.

Reference 1 Name:*

How many years have you known Reference 1 :*

Reference 1 Address:*

Reference 1 Telephone:*

Reference 1 E-Mail:*

example@example.com

Reference 1 Relationship:*

Reference 2 Name:*

How many years have you known Reference 2:*

Reference 2 Address:*

Reference 2 Telephone:*

Reference 2 E-Mail:*

example@example.com

Reference 2 Relationship:*

Reference 3 Name:*

How many years have you known Reference 3 :*

Reference 3 Address:*

Reference 3 Telephone:*

Reference 3 E-Mail:*

example@example.com

Reference 3 Relationship:*

Please include in this section where you attended high school, as well as all college education.

	Name of School/College	Years Attended	Degree Earned	Year Graduated
School 1
School 2
School 3
School 4

Please include any informal or specialized ministerial training you may have had.

Spiritual/Religious Information

Note: Some of our applicants are seeking to take their first steps into ministry, while others are already pastors in other denominations and now wish to join the CEEC. Therefore, please answer all questions completely, and if a question does not apply to you, please mark it N/A.

Salvation

Describe the experience of your coming to a personal faith in Jesus Christ. Please be certain to indicate how long you have been a Christian?*

When were you baptized?*

At what age?*

Of what denomination are you a member?*

Where do you currently attend church?*

Are you the pastor at said church?*

YesNo

If so, how long have you been the Pastor?

Ministerial Call

Describe the experience of your call to the ministry.*

Please describe to what ministry you feel you are called, and what you believe you spiritual gifts to be.*

Please list all ministry licenses and/or ordinations that you have received (i.e., deacon, priest/presbyter, pastor, minister, bishop):

First Ministry Credential:

Date of First Credential:

Date

First Person Officiating:

City, State where first credential was received

Second Ministry Credential:

Date of Second Credential:

Date

Second Person Officiating:

City, State where second credential was received

Third Ministry Credential:

Date of Third Credential:

Date

Third Person Officiating:

City, State where third credential was received

Fourth Ministry Credential:

Date of Fourth Credential:

Date

Fourth Person Officiating:

City, State where fourth credential was received

If any of your ordinations in apostolic succession, please indicate in what denomination/communion the line of succession exists, and the title of the officiant or consecrator.

Date of Diaconal Ordination:

Date

Person Officiating at Diaconal Ordination:

Location of Diaconal Ordination:

Diaconal Denomination or Communion

Date of Priestly Ordination:

Date

Person Officiating at Priestly Ordination:

Location of Priestly Ordination:

Priestly Denomination or Communion

Date of Episcopal Consecration:

Date

Chief Officiant of Episcopal Consecration:

Location of Episcopal Consecration:

Episcopal Denomination or Communion

Note: This section covers criminal history, drug and/or alcohol use and mental health. Please answer all questions. If any questions are answered ‘yes, please elaborate upon the circumstances, history and status on a separate piece of paper. Be advised that ‘yes’ answers will not automatically disqualify you from being ordained in the CEEC, and that all factors will be prayerfully considered and fairly discussed.

Have you ever been convicted of a felony?*