DBMD Form #1

DBMD Form #1

PERSONAL DATA INVENTORY QUESTIONNAIRE
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. If space is not adequate, feel free to attach supplemental sheets.
Date Form Completed

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Name

First NameMiddle NameLast Name
Sex
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone
Please enter a valid phone number.Format: (000) 000-0000.
Cell Phone
Please enter a valid phone number.Format: (000) 000-0000.
Work Phone
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Please Upload a Picture of Yourself

Cancelof
Are you a citizen of the United States/Canada?
If no, please explain:
Do you have a military record?
List branch of service, rank and years served:
Type of discharge:
Special training:

FAMILY RELATIONSHIPS
How many children are in your parent's family?
What position are you?
Briefly survey your childhood home environment, parents' relationship to each other, affection in the home, and your religious training.
Name of father:
Name of mother:
Are your parents living?
Do your parents live together?
Have your parent(s) remarried?
Are your parent(s) professing Christians?
Of what denomination is each a member, if any?
What is your family's attitude toward the prospect of you entering the ministry?

MARITAL STATUS
What is your current marital status?
If single, are you contemplating marriage?

Date of Marriage (If engaged, give planned date of marriage)

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Name of Spouse/Fiancé

First NameLast Name
Spouse/Fiancé Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Is Spouse/Fiancé a citizen of the United States/Canada?
If no, please explain:
Spouse/Fiancé's Education
Explain any hesitancy or resistance your spouse or fiancé may have with your desire to become a minister.
Are you and your spouse maintaining a life of sexual purity and faithfulness in your marriage covenant?
Have you or your spouse ever been involved in sexual activity with a minor?
Are you now living with your spouse?
If not, give explanatory statement.
Have you or your spouse been divorced?
If so, give explanatory statement.
If Divorced, has it been more than once?
Have you or your spouse had a previous marriage terminated by death?
If so, please give date and other information which might help your DBMD understand your situation and loss.
Is your spouse employed?
If so, list her/his position:
Does your spouse plan to continue employment after you are engaged in active ministry?
If so, what type of employment?
Does she/he profess to be converted?
Does she/he profess to be entirely sanctified?
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/complement your ministry.
FAMILY DEPENDENTS

Please list children in order of birth (if applicable):

Rows	Name	Sex	Birth Date	Still a Dependent	Living with You
1
2
3
4

Other dependents and their info (if applicable):

HEALTH INFORMATION
Do you have any serious health or emotional issues that affect your ability to minister to others?
If so, please state the nature of these.
OTHER PERSONAL DATA
Give names of all patriotic, civic, social, fraternal, or athletic societies to which you belong or have belonged.
Have you ever been a member of any organization commonly considered politically subversive?
If so, please give explanatory statement.
Have you ever been a user of tobacco, alcohol, or other harmful drugs?
If so, 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?
If yes, explain fully. (identify each conviction or plea of guilty, when and where each incident occurred, and the sentence received)

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 you held, and the dates employed.
Have you ever been dismissed from a job (other than laid off due to lack of available work)?
If so, what was the job and the reason 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?
What position?
Have you ever been in a position where others were under your supervision?
What position?
List the total amount of indebtedness you presently have:
What is the amount necessary per month to service your debt?
Are you presently or have you ever been in arrears on repayment of any debt or obligation?
If so, explain.
Could your financial obligations, in any way, interfere with your influence as a minister?
If so, how?
Will you make every effort to assure that your influence will not be marred nor bring reproach to the gospel, either by your personal obligations or your lifestyle?

EDUCATIONAL RECORD

Please provide your academic history:

Rows	Name	Dates Attended	Degree or Certificate
High School
College
Seminary
Other

Are you now enrolled or do you plan to enroll in one of our Wesleyan colleges or one of the approved seminaries?
Have you completed any part of the pre-ordination/commissioning course of study?
If so, what courses?
Are you aware of the academic requirements for ordination/commissioning and if licensed by the district, is it your purpose to pursue immediately the course of study and be ordained/commissioned?

RELIGIOUS EXPERIENCE AND CHURCH RELATIONSHIP
Name the church or churches you have attended up to the present time.
Of which local Wesleyan church are you now a member?
How long have you held membership in that church?
Is your spouse or fiancé a member of a Wesleyan Church?
If not, in what church does she/he 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?
If not, will you seek this experience and walk in the light God reveals regarding this experience?
Have you ever held any ministerial position with any church or religious institution?
If so, state institution(s) and dates.
Have you ever resigned from, or been dismissed from, such a position?
If yes, explain fully. (describe 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?
Describe how you were called.
Is it your goal to make the ministry your life's work?
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.
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.”
Have you read, and do you fully subscribe to, the Articles of Religion of The Wesleyan Church as found in the Constitution? (See the Article of Religion at the end of this form or go to paragraphs 210-250 of the Discipline.)
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 listed on the end of this form and in the Discipline 265)
Can you support the entire Church with her departments and institutions?
Have you read, and do you govern your personal life by The Membership Commitments of The Wesleyan Church?
State any reservations you have.
What experience have you had in preaching?
What offices have you held in the local church? (Sunday school, Wesleyan Youth, etc.)
Are you prepared to report regularly to the district?
Describe any hesitancy you may have in accepting the authority, discipline, nurture, and guidance of the District Board of Ministerial Development in regard to evaluating your gifts, graces, and usefulness as you work toward ordination.
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/local church?
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?
In what year do you anticipate you will be ready to be ordained/commissioned?

Please sign the following statement:

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. The information provided on this form is confidential. It is only for use by the Wesleyan District Board of Ministerial Development and Wesleyan Church officials and will not be released or provided to any other parties. 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.
Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

DBMD Form #1

FAMILY RELATIONSHIPS

MARITAL STATUS

FAMILY DEPENDENTS

HEALTH INFORMATION

OTHER PERSONAL DATA

EMPLOYMENT AND FINANCES

EDUCATIONAL RECORD

RELIGIOUS EXPERIENCE AND CHURCH RELATIONSHIP

Please sign the following statement: