A. PERSONAL DATA: 1. Name 2. Date of Birth Soc. Sec. No. Last First Middle. 3. Home Address ( )

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1 APPLICATION FOR ECCLEASTICAL ENDORSEMENT/ORDINATION FOR APPOINTMENT AS CHAPLAIN, CHAPLAIN CANDIDATE CHAPLAINCY OF FULL GOSPEL CHURCHES 150 E Hwy 67, Suite 250 DUNCANVILLE, TEXAS (214) / Fax (972) / Check Chaplaincy Positions for which you are applying: ( ) Army ( ) Navy ( ) Air Force ( ) Army National Guard ( ) Air National Guard ( ) Army Reserves ( ) Navy Reserves ( ) Air Force Reserves ( ) Army Chaplain Candidate ( ) Navy Chaplain Candidate ( ) Air Force Chaplain Candidate ( ) Civil Air Patrol ( ) Veterans Affairs Hospital ( ) Correctional ( ) Civilian Health Care ( ) Work Place ( ) Professional Counselor ( ) Public School ( ) Certified Lay Minister ( ) Police Chaplain ( ) Other For Office Use Only: Date received Application Fee ($25.00) Received Background Check Fee ($100) Received INSTRUCTIONS: Please print or legibly fill out. If you need more space, please feel free to attach separate sheets and indicate accordingly. A. PERSONAL DATA: 1. Name 2. Date of Birth Soc. Sec. No. Last First Middle 3. Home Address ( ) Street or Box City State Zip Telephone ( ) Cell Phone Address Alternate Address 4. Office Address ( ) Street or Box City State Zip Telephone 5. Are you an American citizen? (a) By birth? (b) By naturalization? Give Date: 6. Height 7. Weight 8. Have you any physical defects? if so describe: 9. Any major illnesses? Describe: 10. Have you ever been hospitalized? Reason: (a) Physical (b) Emotional State Nature of illness: 11. Have you ever been charged with or convicted of a criminal offense? When? Where? Charges: 12. Have you ever filed bankruptcy or ever had any serious financial problems? If so, what date? 13. What are your hobbies? 14. Describe musical ability 15. Describe athletic ability Updated June 4, 2014 CFGC Application 1

2 B. DOMESTIC, FAMILY AND/OR MARITAL DATA (Please answer each question; use N/A for all that do not apply) 1. What is your marital status? If married, date of marriage 2. If married, spouses name 3. If married, are you and your spouse living together? 4. Do you have a former living companion? If married, does your spouse? Explain: 5. To what extent does your spouse share your interest in the chaplaincy? 6. If you have children, list name and date of birth of each 7. List permanent name, address, and telephone number of someone other than yourself who will always know where you are. B. MINISTRY AND SPIRITUAL DATA 1. Date of Salvation: 2. Date filled with the Holy Spirit: 3. When were you licensed? By whom? Tel. No.( ) 4. When were you ordained? By whom? Tel. No.( ) 5. Local church affiliation: 6. Have you previously applied for approval or endorsement? What decision was made on your application? 7. Total ministerial experience, beginning with the present and working back: (please use additional sheet if necessary and indicate accordingly.) Church or Employer Address Position Held Dates Served From To D. EDUCATIONAL DATA 1. College and Seminary training (please do not use initials for school names): Name of Colleges Address Attended Major Total Degrees and Seminaries From To Hours Conferred Updated June 4, 2014 CFGC Application 2

3 2. Please send a copy of official transcripts to Chaplaincy of Full Gospel Churches. 3. Have you been in a clinical pastoral residency? If so, how many quarters? 4. Other special training you have received to prepare for the Chaplaincy: E. SECULAR OCCUPATIONAL DATA 1. Occupational experience (list most recent employers): Employer Address Position Dates Served From To F. MILITARY DATA 1. Previous active duty military service: From To Grade Branch Date Date 2. If discharged, type of discharge you received: (a copy of your discharge must accompany this application). 3. If currently in a reserve unit: Name of Organization Address 4. Have you ever been rejected for military service? If so, give details: 5. I hereby grant permission to a member of Chaplaincy of Full Gospel Churches to review my military record CFGC sees a need to do so: l l Yes l l No Updated June 4, 2014 CFGC Application 3

4 G. REFERENCES References are required in order for us to obtain meaningful information from those who know you well enough to evaluate your calling and ministry gifts. A good reference is a professional person who knows what it takes to succeed in a professional career field. This can include previous instructors from college or seminary, if they know you well or current or former professional work colleagues. We will contact the references you provide. Name Telephone # Mailing Address Present Pastor Other Minister Reference Reference Reference H. DISCUSSION (The total number of words for Section H should not exceed 1000 words) 1. Please discuss the following topics and attach as a separate enclosure to this application: a. Explain what being saved means to you. b. Explain why you believe that you are saved. c. Explain what being Spirit-filled means to you. d. Explain why you believe you are Spirit-filled. e. Explain what full gospel means to you. f. Please identify the gift(s) you have operated in through the empowerment of the Holy Spirit. (There is a need to write out scripture passages. You can list the scripture references such as John 3:17). 2. Please discuss the following topics in words total and attach as a separate enclosure to this application: a. Why do you desire to serve as a chaplain? b. Why do you want to be ordained/endorsed by CFGC? c. How have you prepared, are you preparing, yourself for the chaplaincy? d. List, in order of priority, the major function of a chaplain. e. Discuss controversial areas confronting the chaplaincy. f. What do you do most effectively as a minister? g. What do you do least effectively as a minister? h. Your concept of financial stewardship. i. Define holiness. j. Describe your self-care plan. k. Do you have at least one or two persons that you can rely on for personal and spiritual support besides your spouse or CFGC? Updated June 4, 2014 CFGC Application 4

5 STATEMENT: 1. I understand that I must meet each and every requirement for Chaplains of the particular service to which I apply. All education must be fully accredited. 2. I understand that, because of the requirements of the U.S. Armed Forces for security purposes, I will be investigated by the Government and CFGC for background and police records; also, concerning records of sexual harassment/drug/alcohol abuse, bankruptcy, and diseases that might indicate moral laxity. 3. I understand that, if endorsed as a chaplain, I will be working alongside chaplains of other denominations and faith groups, sometimes differing widely with my own views and beliefs. While I will not be asked to compromise my own conscience and beliefs, it is essential, by the very nature of the chaplaincy, that I consider their ordination and ministry as valid as is my own. I must be willing to hold General Protestant worship services as well as those services specifically exercising all my own particular worship style and beliefs. 4. I understand that my Endorsing Agency has the authority to issue and withdraw endorsement if there are violations of established standards. 5. Endorsement is for a specified period of time. Should I prove to be personally and professionally, or by other reason unsuited for the chaplaincy and should CFGC decide that my endorsement should be withdrawn, I agree to abide by its decision. 6. I understand that I am expected to be a Full-Gospel minister. This means that I am expected to be able to freely and without reservation confess that Jesus Christ is Lord, Savior, and Baptizer in the Holy Spirit today, with signs, miracles, and wonders following. Additionally, I am expected to exercise my spiritual gifts in regard to prayer, prophecy, anointing with oil, as the Spirit leads. etc. 7. CFGC is a faith ministry. I understand that this means financial support is dependent upon churches and individuals. As a credentialed member of CFGC, I agree to fulfill my financial obligations to CFGC. Signature: Date: Permanent Address (if different than above) (ST/APT) (CITY) (STATE) (ZIP) (TEL.NO.) No application for ecclesiastical endorsement, recognition, or re-endorsement will be processed without this signed and dated document. By my signature, I certify that the above attached (if applicable) is true and accurate. I understand that falsification of this data in any manner will bring immediate revocation of my endorsement/recognition and/or cessation of the endorsement process. I further understand that if I am ever charged with, convicted of, investigated for any criminal activities; moved because of, or transferred to another position because of any sexual misconduct or sexual harassment, that I will immediately within (48 hours) Contact the Chaplaincy of Full Gospel Churches home office to report the same, and that failure to do so may bring immediate revocation of my endorsement and recognition. Signed: Date: Updated June 4, 2014 CFGC Application 5

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