Nominee Information Form

Nominee Information Form

CALIFORNIA SOUTHERN BAPTIST CONVENTION
Your name has been submitted as a possible candidate to serve on one of the following California Southern Baptist Convention boards or committees. Please select ALL boards or committees you are interested in being part of.

CSBC Executive BoardCalifornia Baptist University Board of TrusteesThe Baptist Foundation of CA Board of DirectorsCSBC Committee on Convention OperationsCSBC Resolutions ComitteeAll
*All nominees must be active members of a cooperating California Southern Baptist Convention congregation, as defined in the CSBC Constitution, ARTICLE III. MEMBERSHIP, Section 2, which reads, in part “Churches shall be considered cooperating which are in sympathy with the purpose of this Convention, having contributed financially to the work of the Convention, from November 1 of the previous year through October 31 of the current year through the Cooperative Program and/or California Mission Offering and who are in agreement with The Baptist Faith and Message as adopted by the Southern Baptist Convention.”
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home phone number *
Please enter a valid phone number.
Work/Cell phone number *
Please enter a valid phone number.
Email*
example@example.com
Date of Birth (Month, Day) *
Occupation
Title
Current Employer
Business/Work Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please list up to two previous employers. (Titles and dates)
Are you an ordained/licensed minister or are youserving in a ministerial or pastoral role in a Southern Baptist Church?

YesNo
Do you consider yourself one of the following?

ministerlayperson
Marital Status:
If married, Spouses name:
If married, anniversary date (Month, Day)
If you have children, please provide their names:
Emergency Contact Information for Pete

First NameLast Name
Emergency Contact phone number
Please enter a valid phone number.
Emergency Contact relationship
Education - Beyond High school. (School name, degree, year graduated)
Church Membership:
Church Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
What date did your membership begin at this church?

MonthDayYear
Date
What is the average worship attendance of your church?
Church Ethnicity

AngloAfrican AmericanHispanicChineseKoreanMulti-culturalOther
Preferred method of contact

telephone calltextemailUS Postal MailOther
What position(s) of service are you currently holding in your church?
Please describe your commitment to Southern Baptists and Southern Baptist causes:
What position(s) of service are you currently holding with your local Baptist association or with any entity ofthe California Southern Baptist Convention or the Southern Baptist Convention?
Please list your previous involvement in the ministries of your local church, association or with any entity of the California Southern Baptist Convention or Southern Baptist Convention. (Please give dates of service for CSBC and SBC involvement.)
What professional/personal skills, abilities, spiritual gifts, or experience are you able to contribute to the ministry of the Board or committee to which you have been recommended?
Please supply one reference of someone who is a member of your church, such as a staff member, church leader, etc.

First NameLast Name
Reference contact
Please enter a valid phone number.
Reference email
example@example.com
Please attach a current photo of yourself. A cell phone picture of your head & shoulders is fine.

Cancelof
If available, please attach a current resume.

Cancelof
Signature

Clear
If you have questions regarding the completion of this form, please contact the CSBC Associate Executive Director, 559/229-9533, Ext. 252, or email: dvillegas@csbc.com.
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