Synod Authorized Minister Application

Synod Authorized Minister Application

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First Name
Middle Name
Last Name
Last Name at birth (if different)
Address
City
State
Zip
Email
example@example.com
Home Phone
Cell Phone
Gender
Pronouns
Birthdate

MonthDayYear
Date
Birthplace
City, State
Baptism Date

MonthDayYear
Date
Baptism Congregation
Baptism City
First Language
Other Languages

ELCA CONGREGATIONAL MEMBERSHIP
Congregation Name
Address

Address

Street Address Line 2

City, State, ZipState / Province

Postal / Zip Code
Member Since
Worship Leadership Experience
Pastor's Name
Pastor's Email
example@example.com
Pastor's Mobile Number
Please enter a valid phone number.

POST-SECONDARY EDUCATION
Please list all of your post secondary education experience; adding the name of the institution, your major, and the year you graduated.
Institution Name
City, State
Major/studies
Years (From/To)
Degree
Institution Name
City, State
Major/studies
Years (From/To)
Degree
Institution Name
City, State
Major/studies
Years (From/To)
Degree

WORK HISTORY

(Please list most recent position first, include military service.)
Please list your employment history for the last 10 years; listing the name of your Employer and the years in which you worked.
Employer
Position/Title
Years (From/To)
City, State
Phone
Employer
Position/Title
Years (From/To)
Phone
City, State
Employer
Position/Title
Years (From/To)
Phone
City, State
Employer
Position/Title
Years (From/To)
City, State
Phone
Employer
Position/Title
Years (From/To)
Phone
City, State
Identify professional certifications or licensure in any specialization.

ENTRANCE ESSAY
The entrance essay is an autobiographical reflection which should contain insights and understandings gained during the period of discernment leading to your decision to apply to the Synod Authorized Ministry of the North Carolina Synod. It is not expected that your discernment is completed. You are asked only to provide an honest assessment of your current self-understanding of your journey thus far and your hope for the future. Your essay will provide the Leadership Team with background that will help guide your interview.

For each of the three parts, please write two to three pages in length, double spaced, and 12 pt. You will be able to upload your essay before you submit this form.
1. Describe your journey of discernment. Where did you hear about Synod Authorized Ministry? How did you first experience a call to pursue this form of lay ministry? With whom have you discussed this sense of call? Through this intentional time of discernment, what have you learned about yourself, the church, and the world?
2. What gifts or skills has God given you which will enrich your ministry as a SAM? Describe your worship leadership experience and how this will prepare you to serve as a SAM.
3. How do you see yourself serving as a SAM? Describe your ideal context. What is your leadership style and how you will walk alongside congregations? What challenges might you anticipate encountering in ministry?
Bring a copy of your essay to your Entrance interview.
Upload your Entrance Essay and any answers to Candidacy Questions.

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I state that the information in this application is true and correct. I hereby apply for entrance into the process for becoming a Synodically Authorized Minister.

Yes
By typing your name below you are signing that all the information in this application is true and correct. I hereby apply for entrance into the process for becoming a Synod Authorized Minister. *
Signature*
Date

MonthDayYear
Date
Printed Name

AUTHORIZATION AND RELEASE
I authorize any references, supervisors, ELCA agencies, congregations, or any other person or organization to give any information, including opinions, regarding my character and fitness for ministry to the SAM Leadership Team of the North Carolina Synod, ELCA. I also release any individual, employer, church, reference, or any other person or organization providing information from any and all liability for damage of whatever kind of nature that may exist at any time on account of compliance or any attempts to comply with this authorization, excepting only the communication of knowingly false information.

An email attachment of this signed form, a facsimile or photocopy of this authorization shall be as valid as the original.
By typing your name below, you are signing that you understand and agree to the above statement. *
Signature*
Date

MonthDayYear
Date
Printed Name
Should be Empty:

Synod Authorized Minister Application

ELCA CONGREGATIONAL MEMBERSHIP

POST-SECONDARY EDUCATION

WORK HISTORY

CANDIDACY QUESTIONS

ENTRANCE ESSAY

AUTHORIZATION AND RELEASE