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  • Chi Alpha Affiliate Application

  • After you submit this application you will recieve an email with next steps. Please follow the instructions promptly to prevent delays in your affiliation and/or account opening process. This email may be directed to junk mail depending on your email host/ settings. If you have follow up questions please don't hesitate to reach out to: applications@chialpha.com.

  • General Information

  • Sex*
  • Format: (000) 000-0000.
  • Birth Date*
     - -
  • Are you a U.S. citizen?*

  • Non U.S. citizens are eligible to affiliate but may require additional processes if applying to open a missions account.

  • Marital Status*
  • Fiancé/ Spouse Birthdate*
     - -
  • Wedding Date/ Anniversary*
     - -

  • If the answer to this question is "yes," we ask that your spouse complete a spouse affiliation application. Your spouse will be sent an email notification containing a link to the spouse affiliation application once your application is submitted.

  • Do you have children 22 or younger?**

  • Application Type

  • In what role are you applying to serve?*
  • Will you be you serving part-time or full-time?*
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  • Do you need a missionary account with Assemblies of God US Missions (AGUSM)? **If you are applying as a staff member and your Spouse is the main account holder please select no to ensure we gather references and a background check.****
  • Are you transferring from Assemblies of God World Missions?*

  • Spiritual History

  • Have you ever been charged with a crime?*
  • Have you ever taken steps to adopt an identity other than your biological sex?*
  • Have you engaged in sexual contact/activity outside a biblically defined marriage (such as incest, adultery, homosexual activity, etc.) in the last five years?*
  • Have you intentionally viewed pornography?*
  • Are you currently walking in freedom from pornography use (free from addiction)?*
  • Have you been water baptized by immersion?*
  • Have you received the Baptism in the Holy Spirit with the initial physical evidence of speaking in tongues?**

  • Training & Education

  • Highest Education Achieved*
  • Have you had any formal Biblical and theological training? (Have you attended Bible College or Seminary in any capacity?)*
  • Do you currently hold ministerial credentials with the Assemblies of God?**
  • Please select which of the following you have attended.*
  • Do you attend church regularly?**

  • References

    Please provide four names and emails below (exclude your spouse and any relatives), they automatically be sent a document that can be electronically signed. Your affiliation process will not be completed without these personal references, so please follow up to make sure that this process is fully complete.

  • Permissions & Sign Offs

  • I give permission to share my phone number with interested students, parents and/or donors looking for connection with our local campus.*

  • Purpose of Chi Alpha:

  • “The purpose of Chi Alpha Campus Ministries is to advance the mission of Jesus Christ on college and university campuses, in cooperation and collaboration with the Assemblies of God worldwide.”*

  • Mission Statement of Chi Alpha:

  • “We reconcile students to Christ, through Spirit-filled communities of prayer, worship, fellow- ship, discipleship, and mission to transform the university, the marketplace, and the world.”

  • Core Values:

  • Chi Alpha Campus Ministries has four core values that shape our identity and actions:

    Disciple-Making Communities
    Cross-Cultural Missions
    Holy Spirit Empowerment
    Healthy Leaders

  • Statement of Beliefs:

  • We believe the Bible is God's message to us, so we seek to understand and obey its truth. We believe there is one God who is three persons, so we yearn to know Him in all of His complexity and beauty. We believe Jesus is fully God and fully human, so we rejoice that Christ can be a bridge between us and God. We believe people throughout history have sinned against God, so we are deeply aware that we too are marked by willful disobedience. We believe God extends forgiveness to us through Christ, so we repent and rejoice in our forgiveness. We believe God offers freedom from sin's grasp, so we live lives that are pleasing to God. We believe followers of Jesus must be empowered by the Holy Spirit, so we expect supernatural power in our daily lives. We believe that God can heal both the body and the heart, so we pray with faith and hope. We believe a mark of surrender to the Holy Spirit is speaking in tongues, so we pray that God would grant us this supernatural gift. We believe in the Church, so we live in this community of faith, inviting others to join us. We believe God gives leaders as gifts to His Church, so we serve those whom the Lord entrusts to us. We believe God commands his followers to celebrate communion and baptism, so we practice these symbolic actions, reflecting on their significance. We believe Jesus will return to claim His Church, so we live in expectancy of His coming. We believe Christ will one day be seen clearly as King on earth, so we live as citizens of His Kingdom now. We believe God is the ultimate Judge, so we live knowing that our choices will echo through eternity. We believe we will live with God forever, so we live with hope regardless of our circumstances.

  • For more details, see the 16 Fundamental Truths of the Assemblies of God.

  • Chi Alpha Campus Ministries Inc., an affiliated ministry of the General Council of the Assemblies of God, requires every Chi Alpha affiliate to:

    • Annually read his/her local campus' Student Conduct Code.
    • Annually read his/her university's Registered Student Organization (RSO) Handbook or equivalent rules and guidelines.

  • By signing below, I certify that

    • I answered all questions truthfully, with the information contained in this application to be correct to the best of my knowledge.
    • I voluntarily and knowingly authorize Chi Alpha to contact the personal references named attached.
    • I understand and agree to abstain from using tobacco, alcohol, marijuana (unless prescribed by a medical doctor), illegal or recreational drugs in any form, and involvement with pornography.
    • I have never been involved and will not be involved with inappropriate sexual contact with a child.
    • I will abstain from sex outside of marriage while under Chi Alpha assignment.
    • I have read and will abide by my university's Student Code of Conduct as well as the university's Registered Student Organization Handbook or equivalent.
    • I affirm my agreement with the 16 Fundamental Truths of the Assemblies of God and agree to not teach contrary to them.
    • I have read and agree to abide by the Chi Alpha Operation Manual.
    • I have read and agree to abide by the Anti-Hazing and Zero Tolerance Policy as stated in the Handbook.
    • I have read and agree to abide by the Code of Ethics as stated in the Operations Manual.
    • I answered all questions truthfully, with the information contained in this application to be correct to the best of my knowledge.
    • I voluntarily and knowingly authorize Chi Alpha to contact the personal references named attached.
    • I commit to living a life free from the addiction of drugs (recreational, prescription, or illegal), alcohol, pornography.
    • I have never been involved and will not be involved with inappropriate sexual contact with a child.
    • I will abstain from sex outside of marriage while under Chi Alpha assignment.
    • I have read and will abide by my university's Student Code of Conduct as well as the university's Registered Student Organization Handbook or equivalent.
    • I agree to not teach contrary to the 16 Fundamental Truths of the Assemblies of God.
    • I have read and agree to abide by the Chi Alpha Operation Manual.
    • I have read and agree to abide by the Anti-Hazing and Zero Tolerance Policy as stated in the Handbook.
    • I have read and agree to abide by the Code of Ethics as stated in the Operations Manual.
  • Please sign below to show your agreement with the Chi Alpha Vision Statement, Chi Alpha's organizational responsibilities for affiliates, the abstinences statement and that you've answered all questions truthfully.*
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