Preliminary Questionnaire

Credential Preliminary Questionnaire

Questionnaires submitted after October 15th—the deadline for January interview consideration—will not be reviewed until after November, and responses will be provided following that timeframe.
Applicant-Full Name (as listed on Driver's License)*

First NameMiddle NameLast Name
Applicant E-mail*
example@example.com
Phone Number

Area CodePhone Number
SingleMarriedDivorcedWidowed
What is your current age?
Spouse Full Name (as listed on Driver's License)

First NameMiddle NameLast Name
Spouse E-mail
example@example.com
Name of Church you are presently attending/member (include city)*
CertifiedLicensedOrdained (if licensed for 2 years)
Please be aware that the Southern Missouri Mnistry Network Bylaws requires all credentialed candidates to be member of an AG Church.
Date of Salvation: blanks* . Date of Water Baptism: blank Date of Holy Spirit Baptism (with evidence of speaking in tongues:
Current Ministry Involvement
YesNo
A divorce recognition application may need to be processed before a credential application can be completed. If you answered yes to the above question, please contact the Network office to discuss.
YesNo
YesNo
Yes-please send us a copy of transcriptsNo- please refer to course requirements on website
Education requirements must be met for credentials. Please forward any transcripts to executivesecretaryassistant@somoag.org.
Should be Empty:

Credential Preliminary Questionnaire