New Member Application Form

Membership Application

To apply for membership please complete all questions.
Application For *

Ordained Ministry Reception - Transfer (for those already ordained) Reception - Dual Recognition (for those already ordained)
Please Note:

Dual Recognition should be used if you want to continue membership in your current Denomination/Fellowship/Network AND you want to be a member of the Convergent Christian Communion.

Transfer should be used if you wish to transfer your affiliation solely to the Convergent Christian Communion.

IMPORTANT: Those seeking to have exisiting Ordinations recognized should be prepared to present evidence of Ordination. Internet Ordinations ARE NOT seen as valid. For an Ordination to be valid the Minister must have been annoited with oil followed by the laying on of hands.

NOTICE OF BACKGROUND CHECK:

All applicants are required to complete a criminal background check, including a check of the US Department of Justice Sexual Offender Registry. Your application will not be considered until this item is completed.

The cost of the background check is approximately $12.00 and can be accessed with the following URL: https://business2.backgroundchecks.com/invitation/welcome/beZM
Have you completed the required Background Check?

Yes No
Name *

First Name Last Name
Gender
If Other
Preferred Gender Pronoun
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
E-mail *
Home Number

Area Code Phone Number
Mobile Number *

Area Code Phone Number
Birth Date *

Month Day Year
Marital Status *
Name of Partner/Spouse
Facebook Link (N/A if none) *
Twitter Handle(N/A if none) *
LinkedIn Link(N/A if none) *
Skype Username(N/A if none) *
What organization and or denomination do you hold credentials with? *
What type of credentials do you have with them? *
When did you get credentials with them? *

Month Day Year
Please Provide a copy of your credentials.

Christian and Spiritual Background
Current denomination and/or spiritual affiliation including dates of affiliation *
Previous denominations and/or other organized spiritual affiliations. Please include approximate dates for each. *
Sacraments
Date of Baptism and name/location of church: *
Date of Confirmation and name/location of church: *
Note: Confirmation is sometimes known as the Rite of Membership. The purpose of this question is to confirm that the applicant is a member of a faith community.
Date of Marriage/Holy Union (if applicable) and name of celebrant/location of ceremony: *
Name of Bishop or other minister you serve under and location: *
What type of studies have you undergone (non-degree related) that were particularly linked to theological/spiritual study (such as Education for Ministry, Community Formation, or other). *

Your Calling
How does your Spouse/Partner feel about you pursuing affiliation with the CCC? *
Why do you want to join the CCC? *
What talents and/or skills do you bring with you in to the CCC *
What is your calling to the ministry? Are you called to be a Elder, Deacon, Chaplain, pastoral caregiver, religious educator, church administrator, other? Explain. *
How did you arrive at this conclusion? *
Well- being
Have you ever been convicted of a felony or any crime against children or a vulnerable population?
If so, please supply details including the state in which the charges were brought and the disposition of the case.
Are you currently being treated for a chronic physical, mental or emotional illness? *
If so, please provide details including diagnosis and prognosis. (The presence of an illness will not disqualify you from ordination and is for the purposes of determining any special needs or considerations you may require).

Character References
REFERENCE #1
Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
E-mail *
Home Number

Area Code Phone Number
Mobile Number *

Area Code Phone Number
How do you know this person?
REFERENCE #2
Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
E-mail *
Home Number

Area Code Phone Number
Mobile Number *

Area Code Phone Number
How do you know this person?
REFERENCE #3
Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
E-mail *
Home Number

Area Code Phone Number
Mobile Number *

Area Code Phone Number
How do you know this person?
Supporting Documentation

You will need to provide, on a separate sheet of paper, the following to be attached to this document:
1. Resume of your present and past work experience. Please include all educational experiences and degrees obtained. Those already ordained, should also include documentation of Ordination.
Resume *
2. Your spiritual autobiography. Explain your personal spirituality. What instances have occurred in your life that have caused you to arrive where you are today in your journey?
Autobiography. *
I do hereby apply for admission to the discernment process of the Convergent Christian Communion. I understand that submission of this application does not guarantee acceptance into the process.

My signature below authorizes the Convergent Christian Communion to conduct a criminal background check at my expense and to verify all information on my application. I understand that I may be required to participate in psychological or other medical testing as a condition of continuing in the process.
Signature
Signature date
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Membership Application

Christian and Spiritual Background

Sacraments

Your Calling

Well- being

Character References

Supporting Documentation