Application for the student to be completed by the pastor.

Please note the $25 fee is non-refundable.

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1. Student's First and Last Name (Required.)

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2. Student's Cell Phone (Required.)

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3. Student's Email Address (Required.)

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4. Student's Mailing Address (Required.)

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5. Student's Gender (Required.)

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6. Student's Date of Birth (Required.)

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7. Church Affiliation (Required.)

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8. Do you intend to pursue the Lay Minister Certificate? (Required.)

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9. Are you a member of the Church of the Nazarene? (Required.)

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10. Have you received approval from your local pastor? (Required.)

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11. Pastor's Full Name (Required.)

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12. Pastor's Cell Phone (Required.)

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13. Pastor's Email Address (Required.)

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