Church Planter Application

We are pleased and excited that you are considering planting a church in the Potomac Ministry Network.

To ensure proper consideration, please fill in the information below as completely and accurately as possible.

NOTE: The form requires a log in (PMN-ChurchPlant) to keep your personal information secure. This is IN ADDITION to the option below - for you to create an account - in order to come back later to finish your application. If you choose this option, both log in's will be required to access your saved form.

Save & Return

Save your progress and complete this form later. (optional)

Personal Information

First Name *

Last Name *

Address 1 *

Address 2

City *

State *

Postal Code *

Cell Phone *

Second Phone (Home/Office/etc.) *

Email Address *

confirm email *

Birth Date *

Age *

Gender *

Social Security# *

Country Citizenship *

Family

Marital Status: Check One *

Spouse's Name *

Wedding Anniversary *

Fiance's Name *

Wedding Date *

Do you have any children? *

Please list children's names and ages: *

Church

Church you currently attend: *

Church City *

Church State *

Pastor *

Church phone: *

Name of presbyter where you presently reside: *

What is your credentialing status? *

Background

Educational Background
(List institutions, dates attended, and date(s) degree conferred, if applicable) *

Other conferences/training events *

Other relevant experiences in church planting *

Finances & Employment

What is your present estimated indebtedness? *

Previous place of employment: *

Current employment: *

Work phone *

Job title *

Annual salary *

Essay Questions

1. Outline your present and past involvement in church and ministry activities.

2. Describe your call to church planting and how your spouse and children
understand their role in this call.

3. What is your personal philosophy of ministry and how does it relate
to the vision and new church planting?

4. In your opinion, what are your 5 major strengths and your 3 major weaknesses?

5. If you have a clear indication of where you would like to plant a church, describe why you
believe you are a good fit to that community. If you do not have a clear indication of where you
would like to plant a church, describe the type of community that fits within your gifts and strengths.

Some helpful things to think about: the ethnicity of the target community, the size of the
community, the needs of the community, other Pentecostal works in the community.

Recommendations

List three persons who are acquainted with your recent ministry, especially those areas of your ministry which most closely relate to your church planting skills.

Reference 1

Name

Title

Phone

Email Address

Reference 2

Name

Title

Phone

Email Address

Reference 3

Name

Title

Phone

Email Address

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