Minister’s Name
*
First Name
Middle Name
Last Name
Has any of the following information changed in the last year?
*
Last Name
Marital Status
Phone Number
Email
Home Address
Mailing Address
Church
Section
None
Minister Level
*
Please Select
Certified
Licensed
Ordained
Minister ID
*
Please include your Minister ID to ensure your application is processed.
Date of Birth
*
/
Month
/
Day
Year
2 digit month, 2 digit day, 4 digit year
Primary Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Home Address
*
Street Address
City
State / Province
Postal / Zip Code
Is your Home Address the same as your Mailing Address?
*
Yes
No
Mailing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What is your Marital Status?
*
Single
Married
Divorced
Widowed
Re-Married
Have you been divorced or re-married since your last renewal?
*
Yes
No
Spouse's Name
*
First Name
Middle Name
Last Name
Spouse's Minister Level
*
Please Select
Certified Minister
Licensed Minister
Ordained Minister
Not a Minister
Spouse's Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Spouse's Email
*
example@example.com
Date of Marriage Anniversary
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Church Name
*
Church Lead Pastor's Name
*
What is your role at the church?
*
Senior Pastor
Lead Pastor
Other (please specify)
Section
*
Please Select
Section 1
Section 2
Section 3
Section 4
Section 5
Section 6
Section 7
Section 8
Section 9
Section 10
Are you renewing as an Active Minister or Senior-Retired Minister?
*
Active Minister
Senior-Retired
Are you 65 or over?
*
Yes
No
Are you currently active in any of the following areas of ministry?
*
Leading a Ministry
Leading a Movement
Leading an Organization
Leading a Church
Assisting a Pastor
Assisting a Ministry
Principle for School of Ministry
Teaching frequently
None
Have you been attending your sectional meetings?
*
Yes
No
How many meetings have you attended?
*
Please Select
0
1-2
2-4
4-6
What are some reasons that may prevent you from attending the ministers’ meetings throughout the year?
*
Distance or travel time
Transportation challenges
Work schedule or job responsibilities
Ministry or church schedule conflicts
Childcare or family responsibilities
Language barrier
Meeting dates or times are inconvenient
Health-related reasons
Personal reasons
Meeting topics or content do not always feel relevant to my ministry or current needs
I am not always aware of the meeting dates or details
Meeting dates or details are sometimes announced too late for me to plan accordingly
Other
Do you feel connected to your sectional leadership and community of ministers?
*
Yes
No
Please share what helps you feel connected and/or any constructive feedback:
0/50
Signature
*
Date of Submission
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
District Renewal Payment
*
prev
next
( X )
Annual District Renewal
$80.00
$
80.00
Debit or Credit Card
Credit Card Number
Security Code
Expiration Month
January
February
March
April
May
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September
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November
December
Expiration Month
Expiration Year
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