Title
First Name
Last Name
Street Address
Mailing Address
City
State/Province or Territory
Country
 

What is the present status of your credentials?
noneOrdainedLicensedexpired licenseSurrendered or lapsed ordaination

If ordained, please list the name of the ordaining organization.

 
 

Have you ever been excommunicated?
YesNo
If the answer is yes, please explain in the box provided.

 

Are you married?YesNo

Have you ever been divorced?YesNo
If yes, please describe cause and when it occured?

 
 

Please select your present ministry classification.
Feel called to the MinistryBishop of DioceseOversee churches or ministriesPresently pastoring in protestant parishPresently pastoring in evangelical churchPresently pastoring in charismatic/pentecostal churchOrdained Pastor but not presently in full time ministryPriest in a traditional sacramental parishPriest in an independent jurisdiction without a parishDeacon or Deaconess in Sacramental parishDeacon or Deaconess in Protestant ChurchHome Church leader evangelicalHome Church leader charismatic/pentecostalMinistry license via internet or long distanceFull time evangelistPart time evangelistMonastic in communityMonastic without present communityCounselorEducatorMissionaryStudentSocial Gospel MinistryMusic Ministry
 

Further information that might be useful about your present status in ministry.

 
 

Please choose a level of education experience
High SchoolGED or High School EquivalantTechnical TrainingSome CollegeSome Bible CollegeAssociates DegreeBachelors DegreeMasters DegreeDoctorate DegreeDenominational TrainingOther

Please list your degree and the name of the granting institution.
Associates Degree
Institution
Bachelors Degree
Institution
Masters Degree
Institution
Doctorate Degree
Institution
Certificate or Diploma
Institution
Other Educational Experience
Institution

Please select your ministry affliation.
noneRoman CatholicMainline "canonical" orthodoxIndependent CatholicIndependent Orthodox Independent sacramentalEpiscopalian/AnglicanPresbyterianMethodistVineyardAssembly of GodChurch of God Clevland,TennesseeChurch of God in ChristIndependent Charismatic/PentecostalIndependent EvangelicalIndependent Bible Centered ChurchSouthern BaptistBaptist otherAfrican Methodist EpiscopalOther

If other, please list

You may enter any additional comments or questions in the box below.

Thank you for your cooperation in answering these questions. When you hit the submit button you will be asked if it is ok to send your email address, if you click "Yes" or "Agree" then your form will be mailed to the COC. You will then be sent back to this page. We ask God to bless you and keep you in your ministry.