Question Title

* 1. Please enter your current contact information

Question Title

* 2. I am a/an:

Question Title

* 3. Please enter your current ministry setting information:

Question Title

* 4. This is a:

Other employment if applicable:

Question Title

* 5. Congregation in which your membership is maintained:

Question Title

* 6. Describe your involvement in ministry in Your local Church during the past year:

Question Title

* 7. Describe your involvement in ministry in the Regional church during the past year:

Question Title

* 8. Describe your involvement in ministry in the General church during the past year:

Question Title

* 9. Describe your involvement in ministry in the Ecumenical  church during the past year:

Question Title

* 10. The practice of ministry involves participation in study, growth and renewal. Indicate experiences by which you have endeavored to strengthen your ministry in these ways during the past 12 months:

Question Title

* 11. Are you willing to be a faithful minister serving within and supportive of the Christian Church (Disciples of Christ)?

Question Title

* 12. Have you reviewed and agree to adhere to the “Ministerial Code ofEthics”?

Question Title

* 13. I have reviewed the Competencies Questionnaire and have concentrated my efforts of self-improvement in the past year on:

Question Title

* 14. Have you ever been charged with or convicted of a felony?

Question Title

* 15. Have you ever been charged with or convicted of any crime against persons?

Question Title

* 16. Is there any reason that you shouldnot be entrusted with the care, guidance or supervision of children or youth?

Question Title

* 17. Are there any ways the Regional Commission on Ministry or the Regional Minister and staff can be of assistance to you at this phase in your ministry?

T