PASTOR
CONTACT INFORMATION
NAME
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Ministerial File#
File number from Ministerial Reports
Ministerial RANK
Exhorter, Ordained Minister, or Ordained Bishop
E-mail
*
CELL Number
*
Format: (000) 000-0000.
Preferred Postal Mailing Address
*
Street Address
Line 2
City
State
Postal / Zip Code
HOME Number
Format: (000) 000-0000.
WEDDING ANNIVERSARY
-
Month
-
Day
Year
Date
SPOUSE'S Name
First Name
Last Name
SPOUSE'S E-mail
example@example.com
SPOUSE'S DOB
-
Month
-
Day
Year
Date
SPOUSE'S Phone
Format: (000) 000-0000.
LOCAL CHURCH
Information
CHURCH
*
Type City and the Church Name on file
CHURCH PHYSICAL Address
*
Street Address
Line 2
City
State
Postal / Zip Code
CHURCH MAILING Address
IF DIFFERENT: Best Mailing Address for the church location.
CHURCH Number
Format: (000) 000-0000.
CHURCH Website
URL Address for website
CLERK/TREASURER
FULL Name of clerk/treasurer
CLERK E-mail Address
MINISTRY HISTORY
PREVIOUS PASTORATES, BEGINNING WITH MOST RECENT
LIST CHURCH / LOCATION / TENURE LENGTH IN YEARS
EDUCATION Completed - Click ALL that Apply
Would you be Willing to start New Church in Virginia?
*
Yes
No
Did You Attend a COG Youth Camp?
*
YES- in Virginia
Yes (not in VA)
No
WERE You Saved at COG Youth Camp?
*
Yes
No
WERE You Called into Ministry at COG Youth Camp?
*
Yes
No
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