Provisional Appl

Application For Provisional Status For Congregations
The following application is an important first step in the process to become a fully credentialed congregation. This form recognizes your intent to be a vital, healthy, and missional congregation in voluntary participation within the Church of God, both nationally (Church of God - Anderson, IN) and regionally (Texas Ministries of the Church of God).

Congregation Information
Congregation Name*
IRS EIN #*
Congregation Mailing Address*

MAILING ADDRESS

MAILING ADDRESS LINE 2

CITYSTATE

ZIP CODE
Is your congregation's physical address the same as the mailing address?*

Yes, both addresses are the same.No, the addresses are different.
Congregation Physical Address*

STREET ADDRESS

STREET ADDRESS LINE 2

CITYSTATE

ZIP CODE
Church Phone Number*
Phone Kind*

Church Specific Phone NumberPersonal Phone Number
Who does this phone number belong to?*
NAME
Church Website
Congregation's Primary Language*

Statement of Affirmation
Please read the affirmation below and have the Lead Pastor sign that he/she and the congregation have read and agree to it.
We, the congregation making application for provisional status, understand that this congregation and our staff are subject to governance by the national Credentials Manual of the Church of God as adopted by the Texas Ministries of the Church of God. We realize this manual and the credentialing processes contained therein may alter over time. We agree to submit to all of its guidelines, norms, and standards, especially those delineated in section 6.11 of the Manual. We further affirm, as noted in the credentials manual, that this congregation will be a partnering congregation, prayerfully, missionally, spiritually, relationally, and financially.*
Lead Pastor's Printed Name*
Date*

MonthDayYear
Date
Should be Empty:

Application For Provisional Status For Congregations